SUMMARY Visually apparent EEG changes associated with damping the internal carotid artery appeared in 55 of 176 consecutive patients (31%) undergoing carotid endarterectomy without shunt. Attenuation of higher frequency activity was the most common change. Changes were moderate in 33 patients (19%) and major hi 22 (12.5%). Major changes usually commenced earlier than less severe alterations. EEG changes resolved within 10 minutes of clamp release in 36 of 55 patients (65%) after an average clamp time of 36.25 minutes.Changes occurred more commonly when pre-operative EEGs were abnormal contralateral to clamping and when the contralateral carotid artery was more than 90% stenosed.Of the inhalational anesthetics employed with nitrous oxide and oxygen, isoflurane was associated with the lowest incidence of damp-associated EEG change.Post-operative strokes occurred in 2 of 22 patients (9%) with major damp-associated EEG changes, none of 33 patients with moderate changes and none of 121 without changes. However, the mechanism of this relationship remains in doubt.
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