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Hypercapnia impact on vascular and neuronal reactivity in patients before and after carotid endarterectomy
Ostrý, Svatopluk ; Stejskal, Lubor (advisor) ; Šonka, Karel (referee) ; Zvěřina, Eduard (referee)
Indications for carotid endarterectomy (CEA) of symptomatic and asymptomatic internal carotid artery (ICA) stenosis were based on numerous randomised studies. The benefit was rated relative to the lowered risk of ipsilateral stroke relapse. There is evidence that rCBF correlates with brain electrical activity (EEG, SEPs). Somatosensory function is represented by evoked neuronal activity in central region. Can the neuronal activity in primary somatosensory cortex be influenced by hypercapnia-induced increased rCBF or CEA in patients with ICA stenosis or is a change such as that permanent? The aim of the present study was to determine whether CEA in unilateral symptomatic stenosis in the extracranial vascular system had a bearing on neuronal activity in the central region of the cerebral cortex. Material and methods The criteria for enrollment in the study were a history of ischaemic insult (TIA, RIND, minor stroke) less than six weeks before admission and unilateral stenosis of the ICA of 70-99 % measured on the DSA with the NASCET method. Patients were divided inti two groups: Group A (28 men and 13 women) with their initial NIHSS ≤ 2. Group B consisted of 12 men and 5 women, starting NIHSS was from 3 to 8. All patients were examined before CEA, on post-operative days 3-7 and 3 months after CEA. SEPs ans...
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