[Can the electroencephalogram contribute to the indications for carotid surgery?]

In a follow-up study (performed in 1981) of patients who underwent endarterectomy because of arteriosclerotic carotid artery stenosis or kinking between 1962 and 1980, those cases were analyzed which did not suffer carotid ischemic attacks but were either asymptomatic or had uncharacteristic symptoms (like dizziness or syncopal attacks) or brain stem symptoms indicating vertebro-basilar insufficiency. In all of these patients EEG recordings were performed before operation. From a total group of 324 patients 44 had abnormal EEG findings. In these cases the incidence of surgical complications was somewhat higher as was the incidence of mortality and of strokes. Particularly in hemodynamically effective stenosis, mortality in the later course was higher in cases with pathologic EEG. Although an abnormal EEG cannot be regarded as an absolute contraindication for carotid surgery, these cases should be submitted to a thorough internistic examination and the indication for surgery should be made carefully.