Cerebral Blood Flow, Metabolism and Mean Arterial Pressure Changes Following Unilateral Internal Carotid Endarterectomy: Cerebral Ischemia and Elevated Systemic Arterial Pressure

Cerebral blood flow and metabolism studies were performed on 13 patients before and after unilateral carotid endarterectomy for severe atheromatous occlusive disease. Mean brachial arterial pressure was monitored during these studies. Postoperative studies compared to a control group revealed a rise in cerebral blood flow and a fall in mean arterial pressure and cerebral vascular resistance. The clinically recorded blood pressure in the study group compared to closely matched control patients with cerebral vascular disease showed a similar but not significant difference. Ten patients studied following ligation of a common carotid artery had a small but significant increase in mean systemic arterial pressure. These results suggest a relationship between systemic arterial pressure and cerebral ischemia. Some possibilities for this relationship are discussed.