The selection of patients for intracranial and extracranial surgery for cerebrovascular occlusive disease.
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Biomedical subjects
Publications and source records attributed to B A Sandok.
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A system of grouping patients according to preoperative evaluation of risk of carotid endarterectomy is presented. The primary complications of this surgical procedure were myocardial infarction and residual mild to severe neurologic deficit. Neurologically stable patients without medical or angiographically determined risk factors (group 1, 129 patients) have a risk of 1%. Neurologically stable patients without medical risk but with angiographically determined risk (group 2, 56 patients) have a risk of 2%. Neurologically stable patients with significant medical illness and with or without angiographically determined risks (group 3, 76 patients) have a risk of 7%, primarily related to cardiac disease. Neurologically unstable patients (group 4, 70 patients) have a 10% risk for a neurologic deficit.
Two patients with herpes simplex encephalitis had clinical courses consisting of an acute febrile illness with early onset of seizures and rapidly progressive neurologic signs evolving to coma and death within 3 weeks. The electroencephalograms of both patients were similar and showed widespread, periodic, stereotyped sharp-and-slow-wave complexes occurring bilaterally over both hemispheres, as well as transient episodes of electrographic seizure activity occurring unilaterally, with suppression of the periodic activity on that side. Although the electroencephalographic findings are not pathognomonic, when associated with an acute encephalitic process, they would suggest the diagnosis of herpes simplex encephalitis.
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