Skip to main content Accessibility help

We use cookies to distinguish you from other users and to provide you with a better experience on our websites. Close this message to accept cookies or find out how to manage your cookie settings.

Close cookie message
×
Hostname: page-component-cd9895bd7-8ctnn Total loading time: 0 Render date: 2024-12-27T15:34:13.307Z Has data issue: false hasContentIssue false

Case 28 - Neurologicdecline after carotid surgery

from Section I - Neuroanesthesia

Published online by Cambridge University Press:  03 May 2011

By
Phil Gillen
Edited by
George A. Mashour  and
Ehab Farag
George A. Mashour
Affiliation:
University of Michigan
Ehab Farag
Affiliation:
Cleveland Clinic
Get access

Summary

The perioperative management of patients undergoing carotid endarterectomy (CEA), along with attempts to prevent its associated neurologic decline, continues to be a challenge to clinicians. Due to the marked changes in cerebral perfusion, there is a spectrum of neurologic sequelae directly attributable to this procedure, ranging from intraoperative stroke and death to more subtle perioperative neurocognitive deterioration. This chapter presents a case study of a 68-year-old male with demonstrated occlusive cerebrovascular disease with a history of a right- internal carotid artery (ICA) territory transient ischemic attack (TIA) 3 months previously. Blood pressure control has long been recognized as crucial during and after CEA to prevent critical hypo- or hyperperfusion states. The performance of CEA under local anesthesia has the potential to demonstrate immediate neurologic decline. Further investigation is warranted to ensure the best neurologic outcomes in patients undergoing this common procedure.

Keywords

nitrous oxidehemodynamic stabilityneurophysiologic monitoringneurosurgerydexmedetomidineanesthesiacerebral aneurysm clipping
Type
Chapter
Information
Case Studies in Neuroanesthesia and Neurocritical Care , pp. 91 - 93
Publisher: Cambridge University Press
Print publication year: 2011

Access options

Get access to the full version of this content by using one of the access options below. (Log in options will check for institutional or personal access. Content may require purchase if you do not have access.)

Save book to Kindle

To save this book to your Kindle, first ensure no-reply@cambridge.org is added to your Approved Personal Document E-mail List under your Personal Document Settings on the Manage Your Content and Devices page of your Amazon account. Then enter the ‘name’ part of your Kindle email address below. Find out more about saving to your Kindle.

Note you can select to save to either the @free.kindle.com or @kindle.com variations. ‘@free.kindle.com’ emails are free but can only be saved to your device when it is connected to wi-fi. ‘@kindle.com’ emails can be delivered even when you are not connected to wi-fi, but note that service fees apply.

Find out more about the Kindle Personal Document Service.

Available formats
×

Save book to Dropbox

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Dropbox.

Available formats
×

Save book to Google Drive

To save content items to your account, please confirm that you agree to abide by our usage policies. If this is the first time you use this feature, you will be asked to authorise Cambridge Core to connect with your account. Find out more about saving content to Google Drive.

Available formats
×