[Cervical carotid endarterectomy for vertebrobasilar insufficiency]

A 66-year-old man was admitted with 2-year history of progressing gait difficulty and speech disturbance. His neurological examination on admission demonstrated dysarthria, truncal ataxia, mild foot weakness and emotional incontinence. Computerized tomography revealed enlarged ventricle with marked brain stem atrophy. Cerebral angiography showed 90% stenosis of left upper vertebral artery, 90% stenosis of mid basilar artery, occlusion of right upper vertebral artery and 50% stenosis with ulcer of right cervical carotid artery. Right cervical carotid endarterectomy was carried out with continuous electroencephalography (EEG) monitoring. Post-operative course was uneventful and the patient had gradual neurological improvement. This case was reported to be of help to judge the indication of such operation in effectiveness and also the value of EEG monitoring during operation.