Neuropsychological impairment after carotid endarterectomy correlates with intraoperative ischemia.

Detailed neuropsychological assessments were performed before and shortly after carotid endarterectomy in thirty-four patients. The degree of intraoperative ischemia was assessed by monitoring the somatosensory evoked cortical potential change upon carotid clamping. Changed neuropsychological performance was found to be related to intraoperative ischemia most clearly in patients with a history of previous stroke and in those with more severe vascular disease. In such patients greater SSEP change was correlated with greater neuropsychological change postoperatively.