MONITORING CAROTID TEST OCCLUSIONS WITH CONTINUOUS EEG AND CLINICAL EXAMINATION

We routinely monitor invasive neuroradiologic carotid balloon test occ lusions with continuous polygraph and quantitative EEG along with repe ated detailed clinical examinations. Four of 17 consecutive cases show ed changes during carotid occlusion. In one instance, an immediate del ta increase was accompanied by slurred speech and aphasia. Another sho wed alpha attenuation without clinical change. A third patient had sig nificant clinical change without EEG change. Nine of the 17 cases unde rwent permanent therapeutic carotid occlusion as treatment of an intra cerebral vascular abnormality. Seven of these nine had no EEG or clini cal changes during monitoring and have had no functional abnormalities on follow-up. The patient with focal alpha attenuation had an acciden tal balloon detachment but has had no functional or structural neurolo gic abnormalities. The patient with minor regional increased delta rec eived a permanent carotid occlusion and went on to develop clinical si gns 24 h later. We believe that continuous EEG monitoring and repeated clinical examinations provide useful ways of evaluating cerebral circ ulation during carotid test occlusions.