NEUROPHYSIOLOGICAL CRITERIA FOR THE EFFECTIVENESS OF EARLY CAROTID ENDARTERECTOMY IN ATHEROTHROMBOTIC STROKE
Abstract
Introduction. The advantages of surgical treatment over conservative methods in patients with hemodynamically significant narrowing of the carotid arteries are currently being actively discussed. The main controversial issues at present are the time from the onset of stroke to surgery and the criteria for selecting patients for the intervention. In recent years, neurophysiological methods for studying spontaneous and evoked brain activity have become most relevant, which can identify functional disorders that have important prognostic significance. The purpose of the study was to study the dynamics of spectral-coherent EEG indicators and indicators of somatosensory evoked potentials in patients with ischemic atherothrombotic stroke of varying severity, who underwent carotid endarterectomy on the side of the infarction in the acute period. Materials and methods. We examined 105 patients with ischemic stroke who underwent carotid endarterectomy in the acute period, and analyzed the dynamics of spectral and coherent EEG characteristics in the postoperative period. The dynamics of power spectra and intrahemispheric EEG were compared. Research results. It has been shown that severe depression of alpha activity on the side of both hemispheres is an unfavorable prognostic factor for carotid endarterectomy and restoration of impaired functions after surgery. The presence of a stage of increasing alpha rhythm power on the side of the clinically intact hemisphere with simultaneous depression of the alpha rhythm on the side of the affected hemisphere in the postoperative period is a favorable prognostic factor for the restoration of impaired functions and correlates with a statistically significant decrease in the severity of neurological deficit.
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