ID 377 – Somatosensory evoked potentials as a predictor of clinical outcome after emergent recanalization of internal carotid artery occlusion

Objectives Median somatosensory evoked potential (SEP) amplitude monitoring is reliable tool for early cerebral ischemia detection. Aim of the study Set feasibility of routine SEP monitoring in emergent internal carotid artery (ICA) recanalization. Material and methods 05/2013 to 02/2015 were performed 12 emergent ICA recanalisations after acute ischaemic stroke (AIS). Mean age 72.7; ICA occlusion: 6 (50%), 90-99% stenosis: 6 (50%). Inclusion criteria: AIS or crescendo TIA 24 hours, ICA occlusion or stenosis, functional independence before stroke. Exclusion criteria: hemorhagic stroke, ischaemia on CT scan. Median SEP were monitored during carotid surgery. Clinical finding was evaluated 3 months after surgery. Results N20/P25 amplitude was decreased in 5 (41.7%) at symptomatic side (in 1 by > 50%) comparing to asymptomatic. Successful recanalisation: 11 (91.7%), intraluminal shunt was placed in 1 according SEP amplitude decrease intraoperatively. Mean muscle strength: arm: 2.4, leg: 3.3, speech disorder: 8 (66.7%). 3 month outcome: muscle strength: 3.9, 4.4 respectively, speech disorder: 3 (25.0%). Modified Rankin Score 0-1: 8 (66.7%), mRS 2: 3 (25.0%), mRS 6: 1 (8.3%). Conclusion Median SEP is feasible to monitor in emergent ICA recanalizations. Median SEP amplitude seems to be promising marker of good clinical outcome.