During Carotid Endarterectomy (CEA), which monitoring procedure is essential?

During Carotid Endarterectomy (CEA), monitoring both hemispheres is essential because this procedure involves significant risk to brain tissue, particularly in relation to cerebral blood flow. Maintaining awareness of the cortical activity in both hemispheres allows for the detection of potential ischemic events that may occur due to compromised blood flow during vessel manipulation and clamping.

Monitoring solely from the compromised hemisphere could miss vital information regarding the condition of the unaffected hemisphere, which can also be adversely impacted by changes in perfusion and collateral circulation. Therefore, dual hemisphere monitoring provides a comprehensive assessment to ensure immediate detection of any neurological deficits that may arise during the surgical procedure.

Additionally, discontinuing monitoring following clamp removal does not provide adequate insight into the immediate recovery phase of cerebral perfusion, and recording a full minute of EEG baseline isn't practical when rapid changes are needed to identify ischemic conditions. Thus, continuous monitoring of both hemispheres is crucial in ensuring patient safety and optimizing outcomes during CEA.