Electroencephalogram combined with regional oxygen saturation in monitoring cerebral perfusion during carotid endarterectomy / 中华神经医学杂志

Objective:To investigate the application value of electroencephalogram (EEG) combined with regional cerebral oxygen saturation (rSO 2) in monitoring cerebral perfusion during carotid endarterectomy (CEA). Methods:A retrospective analysis of clinical data of 42 patients with atherosclerotic carotid artery stenosis admitted to and accepted CEA in our hospital from January 2018 to December 2019 was performed. CEA was performed under EEG combined with rSO 2 monitoring. The efficacy and safety of EEG combined with rSO 2 in monitoring cerebral perfusion abnormalities during CEA were analyzed. Results:After carotid artery occlusion, 24 patients (57.1%) had normal EEG and rSO 2; 15 (35.7%) had abnormal changes of EEG, among whom 13 (31.0%) were accompanied by rSO 2 anomaly; 16 (38.1%) had abnormal rSO 2, among whom 13 (31.0%) were accompanied by EEG anomaly. Of these 18 patients with abnormal EEG and/or rSO 2 monitoring, 17 patients recovered after increasing their blood pressure and 1 patient recovered after diverter tube usage. Intraoperative EEG and rSO 2 monitoring results were consistent (Kappa=0.745, P=0.000). The positive rates of combined monitoring, EEG alone or rSO 2 alone were 42.9%, 35.7% and 38.1%, respectively. All patients were evaluated clinically and radiologically before discharge, and no new ischemic lesions or clinical symptoms were found. Conclusions:EEG and rSO 2 monitoring are well consistent in CEA; the combined monitoring can make up for the deficiency of single monitoring to increase surgical safety.

Recent advance in common complications and management after revascularization of moyamoya disease / 中华神经医学杂志

Moyamoya disease (MMD) is a kind of chronic, occlusive cerebrovascular disease of unknown etiology, characterized by bilateral steno-occlusive changes at the terminal portion of the internal carotid artery and with the development of collateral vessels (Moyamoya vessels) at the base of the brain. Surgical revascularization is an efficient way to treat MMD. But there is rare systemic analysis about complications after revascularization and perioperative management of MMD in the domestic and foreign articles at present. In order to improve the surgical treatment outcomes, and decrease the incidence of complications after revascularization, we review the latest articles about common complications after revascularization of MMD.