Key result
Processed EEG proves less reliable than awake assessment for detecting cerebral ischaemia due to false positives.
Why the study?
Does processed EEG compared to awake neurological assessment improve the detection of cerebral ischaemia in patients undergoing carotid endarterectomy?
Observational (n=70)
Does processed EEG compared to awake neurological assessment improve the detection of cerebral ischaemia in patients undergoing carotid endarterectomy?
Processed EEG is less reliable than awake neurological assessment for detecting cerebral ischemia during carotid endarterectomy due to false negatives, false positives, and technical issues.
Processed EEG should not replace awake assessment in carotid endarterectomy; leaves open whether refined algorithms improve reliability in future studies.
A processed electroencephalogram (EEG) produced by the Lifescan monitor (Neurometrics), was compared to awake neurological assessment for detecting cerebral ischaemia in seventy patients undergoing carotid endarterectomy under cervical plexus block. Of the six patients demonstrating neurological signs on cross-clamping the carotid, five displayed simultaneous EEG changes, four being detected during surgery, and one being detected after reviewing the EEG postoperatively. Another four patients displayed EEG changes indicative of ischaemia but unassociated with neurological signs. A further patient displayed contralateral intraoperative EEG changes. Hypotension resulted in one EEG change and two cases were associated with technical difficulties with the monitor. The presence of false negatives, possible false positives, technical errors and subjective interpretation associated with the processed EEG make it less reliable than awake neurological assessment for the detection of cerebral ischaemia.
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Silbert et al. (1989) conducted an observational in Patients undergoing carotid endarterectomy (n=70). Processed electroencephalogram (EEG) vs. Awake neurological assessment was evaluated on Detection of cerebral ischaemia. Processed EEG detected changes in 5 of 6 patients with neurological signs of cerebral ischaemia, but was deemed less reliable than awake assessment due to false positives and technical errors.