Cloughesy T F, Nuwer M R, Hoch D, Vinuela F, Duckwiler G, Martin N
Department of Neurology, University of California at Los Angeles 90024-6987.
J Clin Neurophysiol. 1993 Jul;10(3):363-9. doi: 10.1097/00004691-199307000-00010.
We routinely monitor invasive neuroradiologic carotid balloon test occlusions with continuous polygraph and quantitative EEG along with repeated detailed clinical examinations. Four of 17 consecutive cases showed changes during carotid occlusion. In one instance, an immediate delta increase was accompanied by slurred speech and aphasia. Another showed alpha attenuation without clinical change. A third patient had significant clinical change without EEG change. Nine of the 17 cases underwent permanent therapeutic carotid occlusion as treatment of an intracerebral vascular abnormality. Seven of these nine had no EEG or clinical changes during monitoring and have had no functional abnormalities on follow-up. The patient with focal alpha attenuation had an accidental balloon detachment but has had no functional or structural neurologic abnormalities. The patient with minor regional increased delta received a permanent carotid occlusion and went on to develop clinical signs 24 h later. We believe that continuous EEG monitoring and repeated clinical examinations provide useful ways of evaluating cerebral circulation during carotid test occlusions.
我们常规通过连续多导生理记录仪和定量脑电图，以及反复详细的临床检查来监测侵入性神经放射学颈动脉球囊试验闭塞情况。在连续17例病例中，有4例在颈动脉闭塞期间出现了变化。其中1例，即刻出现δ波增加，并伴有言语不清和失语。另一例显示α波衰减，但无临床变化。第3例患者有明显临床变化，但脑电图无变化。17例中有9例接受了永久性治疗性颈动脉闭塞，作为一种脑血管异常的治疗方法。这9例中的7例在监测期间脑电图和临床均无变化，随访中也无功能异常。出现局灶性α波衰减的患者发生了球囊意外脱落，但无功能或结构性神经异常。δ波轻度区域性增加的患者接受了永久性颈动脉闭塞，24小时后出现了临床体征。我们认为，连续脑电图监测和反复临床检查为评估颈动脉试验闭塞期间的脑循环提供了有用的方法。
