Transcranial Doppler monitoring during carotid endarterectomy - A technical case report

We report a case involving a patient undergoing carotid endarterectomy in w hom transcranial doppler monitoring demonstrated impaired cerebral blood no w during the initial dissection of the carotid artery, during cross-clampin g of the carotid artery, and after the shunt was kinked inadvertently. Only when the carotid artery was cross-clamped were these ischemic changes also seen by electroencephalography. During the other episodes, the electroence phalography tracings demonstrated no detectable changes. This case illustra tes the importance of using multiple modalities to determine the adequacy o f cerebral blood flow and neuronal integrity.