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James R. Elmore, MD; Jens Eldrup-Jorgensen, MD; William H. Leschey, MD; William E. Herbert, MD; Richard C. Dillihunt, MD; Ferris S. Ray, MD

Arch Surg. 1990;125(6):734-738.

Abstract
• Computerized topographic brain mapping processes standard electroencephalographic data and displays it in a color map, thus simplifying interpretation. During a 2-year period, 65 carotid endarterectomies were performed with the use of brain mapping as the sole criterion for shunt placement. Forty-three patients (66%) were found to have abnormal brain maps preoperatively. Ten patients (15%) developed ischemic changes after cross-clamping (all resolved after shunt placement). Postoperative brain maps were unchanged in 54 patients (83%) and improved in 7 patients (11%). A new, small focal abnormality was identified in 4 patients without shunts (6%), none of whom had a change in neurologic status. The overall major morbidity and mortality was 1.5%. Computerized brain mapping is a sensitive and readily interpretable means of monitoring cerebral perfusion during carotid surgery. We found the computerized electroencephalographic data to be a dependable criterion for selective shunting and for confirmation of shunt patency during carotid endarterectomy.

(Arch Surg. 1990;125:734-738)

Author Affiliations
From the Department of Surgery (Drs Elmore, Eldrup-Jorgensen, Herbert, Dillihunt, and Ray) and Division of Neurology (Dr Leschey), Maine Medical Center, Portland.

Footnotes
Accepted for publication January 30, 1990.

Read before the 70th Annual Meeting of the New England Surgical Society, Bretton Woods, NH, September 22, 1989.

Reprint requests to Department of Surgery, Maine Medical Center, 22 Bramhall St, Portland, ME 04102 (Dr Ray).

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