Krul J M, Ackerstaff R G, Eikelboom B C, Vermeulen F E
Department of Clinical Neurophysiology, St. Antonius Hospital, Nieuwegein, The Netherlands.
Eur J Vasc Surg. 1989 Oct;3(5):423-8. doi: 10.1016/s0950-821x(89)80050-7.
EEG recordings from 230 carotid endarterectomies performed with an automatic EEG monitoring system were reviewed with the purpose of establishing the exact relation between EEG changes and intraoperative stroke. Patients were selectively shunted, based on the EEG changes occurring after carotid cross-clamping. Transient EEG asymmetry was not associated with intraoperative stroke. Only persisting EEG asymmetry reflected intraoperative major stroke, expressed by a positive predictive value of 0.50, but also in terms of specificity (0.99), sensitivity (0.80) and diagnostic gain (47.8%) of the EEG; minor strokes could not be detected with EEG monitoring. Analysis of the time course of the persisting asymmetry confirmed the thrombo-embolic origin of the majority of the major strokes.
回顾了使用自动脑电图监测系统进行的230例颈动脉内膜切除术的脑电图记录，目的是确定脑电图变化与术中中风的确切关系。根据颈动脉夹闭后出现的脑电图变化，对患者进行选择性分流。短暂性脑电图不对称与术中中风无关。只有持续的脑电图不对称反映术中的严重中风，其阳性预测值为0.50，脑电图的特异性为0.99，敏感性为0.80，诊断增益为47.8%；脑电图监测无法检测到轻微中风。对持续不对称的时间进程分析证实了大多数严重中风的血栓栓塞起源。
