The value of routine computed tomography of the brain in the pre-operative assessment of patients for carotid endarterectomy.
OBJECTIVE
To determine the prevalence of brain infarcts and other intracranial pathology on computed tomography (CT) in patients with greater than 50% internal carotid artery stenosis.


METHODS
Descriptive study of CT findings.


METHODS
Referral-based cohort at Groote Schuur Hospital.


METHODS
Sixty-three patients aged 40-82 years who had CT of the head prior to carotid endarterectomy.


METHODS
Prevalence of brain infarct in patients presenting with transient ischaemic attack (TIA) or stroke, and yield of unsuspected intracranial pathology other than ischaemic necrosis.


RESULTS
Brain infarcts were diagnosed in 54% of patients presenting with TIA and in 73% of patients with stroke. True-positive CT scans were present in only 19% and 44% of patients with TIA and stroke, respectively. A single incidental frontal lobe granuloma, unrelated to the patient's clinical presentation, was noted.


CONCLUSIONS
In the selected group of patients referred for carotid endarterectomy, routine use of CT of the head is not indicated and can be reserved for cases with extraordinary clinical features.
Stuve
O
O
Department of Surgery, Groote Schuur Hospital, Cape Town.
Louwrens
H
H
Hill
J
J
Immelman
E J
EJ
D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D001921:Brain / Q000000981:diagnostic imaging* / Q000601:surgery; D016894:Endarterectomy, Carotid; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D014057:Tomography, X-Ray Computed