Long term EEG analytical and neurological follow-up study in completed stroke patients after extra-intracranial vascular anastomosis.
In 33 chronic stroke patients, who had internal carotid or middle cerebral artery occlusion that resulted in neurological deficit persisting for an average of more than 10 weeks, it was possible to perform a postoperative follow-up study for a period of six to eight years after extra-intracranial vascular anastomosis. Serial neurological examinations with grading of motor deficit and EEG analyses were performed to assess the clinical course of the cerebral lesion. These long term examinations showed a postoperative continuing improvement of electrical brain activity in nearly two thirds of the patients, nine patients showed no significant changes and three worsened. The EEG analytical findings correlated well to the neurological findings. An increase of electrical brain activity was bilateral with accentuation over the affected hemisphere, a phenomenon known from follow-up nrCBF measurements after anastomosis. During the follow-up one patient died five years, one six years following stroke under signs of cardiovascular disease, and one after six years suffering from a recurrent stroke opposite to the side of anastomosis. In conclusion the findings indicate that EEG analysis is of value for assessment of long term follow-up of cerebral ischaemic lesions, chronic ischaemic alterations of the brain can be improved by anastomosis, and especially in comparison to a non-operated group of stroke patients, the course of the operated one seemed to be more advantageous, as the five-year survival rate of the Framingham study for stroke victims is 69%.