[Value of X-ray computed tomography of the brain in controlled carotid surgery].
The usefulness of computerized tomography (CT) in elective carotid surgery was evaluated in a prospective study of 402 patients who had a surgical operation on one or two atheromatous arteries and were explored by pre and post-operative CT of the brain. Pre-operative CT scans revealed an ischaemic lesion in 22 per cent of asymptomatic patients and in 29 per cent of patients who had experienced a transient ischaemic accident. Abnormal pre-operative CT scans were associated with a statistically significant increase in per-operative electroencephalographic changes, but there was no significant increase in post-operative neurological complications. Post-operative CT scans showed a "silent" infarct in 6 per cent of the cases; 59 per cent of patients with neurological complications had normal or unchanged post-operative CT images. This study suggests that pre-operative CT is not necessary to evaluate the neurological risk and that post-operative CT alone is inadequate to quantify the morbidity of carotid surgery.
Bouttier
S
S
Clinique chirurgicale, Hôpital Beaujon, Clichy.
Andreassian
B
B
Colombani
J M
JM
Prier
S
S
Jais
J P
JP
Goldfarb
B
B
D000368:Aged; D001161:Arteriosclerosis / Q000601:surgery*; D001921:Brain / Q000000981:diagnostic imaging*; D002545:Brain Ischemia / Q000000981:diagnostic imaging; D002340:Carotid Artery Diseases / Q000601:surgery*; D002533:Cerebral Angiography; D002544:Cerebral Infarction / Q000000981:diagnostic imaging*; D004569:Electroencephalography; D005260:Female; D006801:Humans; D008297:Male; D009422:Nervous System Diseases / Q000000981:diagnostic imaging; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D011446:Prospective Studies; D014057:Tomography, X-Ray Computed
Intérêt de la scanographie cérébrale dans la chirurgie carotidienne réglée.