Neurologic deficit following carotid endarterectomy

Neurologic deficit immediately following carotid endarterectomy, most commonly, is the result of a technical error. Permanent neurologic deficit developed in nine patients and temporary neurologic deficit developed in seven in the early postoperative period. The cause was determined by immediate re-exploration or angiography in eight of the nine of the permanent deficit group, and a technical error was demonstrated in six. The cause of the temporary deficit was determined in four of seven patients. Emboli were the cause in three patients and coagulation abnormality was the cause in the fourth. Patients in whom deficits developed in the early postoperative period should immediately undergo exploration. If thrombosed, a thrombectomy and revision of the repair should be done and, if patent, operative angiography should be performed to identify abnormalities which should be corrected.