ARE NEUROLOGIC EVENTS OCCURRING DURING CAROTID-ARTERY SURGERY PREDICTIVE OF POSTOPERATIVE NEUROLOGIC COMPLICATIONS

Background. Per- and postoperative neurologic complications occurring during carotid artery surgery may be related to different mechanisms. Nevertheless, recent studies suggest that they are related and that pa tients who develop reversible neurologic events peroperatively are at risk of postoperative neurologic complications. We, therefore, studied 265 patients operated under regional anaesthesia to assess the incide nce and the pathogenesis of per- and postoperative neurologic disorder s and their relationship. Method. Neurologic function was adequately a ssessed in 261 patients during surgery. The operation was uneventful i n 234 patients, while 27 suffered from transient ischaemic neurologic deficit occurring mainly during carotid artery clamping. Results. Post operative neurologic complications occurred in 6 (2.5%) of the patient s who were symptom-free during surgery and in 1 (3.7%) of the patients who experienced neurologic deficit during surgery (NS). In this group , two additional patients had peroperative neurologic deficit which la sted a few hours postoperatively so that the total incidence of postop erative neurologic deficit (11.1%) was significantly higher than in th e other group (P<0.05). Emboli (N=3) and carotid artery thrombosis (N= 3) were the main causes of postoperative neurologic deficit. Conclusio n. We conclude that patients who have suffered from a peroperative neu rologic complication were more frequently in an unstable neurologic co ndition postoperatively However, the incidence of ''new'' neurologic d eficit, separated by a free interval from the one occurring peroperati vely, was not significantly different in this group.