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J Stroke Cerebrovasc Dis. 2019 Feb;28(2):458-463. doi: 10.1016/j.jstrokecerebrovasdis.2018.10.024. Epub 2018 Nov 7.

Carotid Artery-Related Perioperative Stroke Following Anterior Cervical Spine Surgery: A Series of 3 Cases and Literature Review.

Author information

1
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China.
2
Department of Neurosurgery, Xuanwu Hospital, Capital Medical University, Beijing 100053, China. Electronic address: fengzengjian@hotmail.com.

Abstract

BACKGROUND:

Vascular complications following anterior cervical spine surgery are rare but potentially devastating. Complications associated with the carotid artery are even more disastrous but largely anecdotal, with no more than 4 reported cases.

MATERIALS AND METHODS:

We report 3 new cases of carotid artery-related perioperative stroke following anterior cervical spine surgery. All 3 patients had carotid artery atherosclerosis and the time of intraoperative carotid artery retraction was longer than 1 hour. One patient underwent hypotension during surgery. Risk factors as well as prevention and management protocols of carotid artery-related perioperative stroke based on the literature review and our clinical experience are discussed.

CONCLUSIONS:

Carotid artery-related perioperative stroke following anterior cervical spine surgery is extremely rare. Prolonged traction, carotid artery atherosclerosis, and intraoperative hypotension can produce cerebral hypoperfusion and cause ischemic stroke. Preoperative risk assessment, adequate perioperative manipulation, and postoperative management can minimize overall morbidity and mortality.

KEYWORDS:

Cervical spine; anterior surgery; carotid artery; ischemic stroke; vascular complication

[Indexed for MEDLINE]

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