Contact thermography using liquid crystals provides a simple, inexpensive method of evaluating carotid disease. It does not duplicate information provided by other noninvasive methods, because, whereas Dopplers give an indication of flow and degree of stenosis in the artery, thermography measures the actual hypoperfusion as demonstrated by diminished temperature in areas of the forehead supplied by branches of the ophthalmic artery.
A 74-year-old man presented with bilateral carotid distribution TIAs. Carotid Dopplers and angiography revealed 99% occlusion of both internal carotid arteries. Contact thermography showed diminished temperature in the right supraorbital artery territory. The patient subsequently underwent carotid endarterectomy. Following induction of anesthesia but prior to carotid clamping, the patient became transiently hypotensive. Intraoperative EEG monitoring showed marked attenuation of the background rhythm on the right with preservation of background on the left. Normal rhythm was quickly restored with pharmocologic restoration of the blood pressure. This case illustrates the usefulness of thermography, which predicted the hemisphere in jeopardy when Dopplers and angiography showed equal bilateral disease.
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References
1.
Wood EH: Thermography in the diagnosis of cerebrovascular disease. Radiol85:270, 1965.
Capistrant TD , Gumnit RJ: Thermography following a carotid transient ischemic episode. JAMA211:656-657, 1970.
4.
Hofferberth M., Gottschaldt S., Dykan S.: Comparison of Doppler sonography and plate thermography for detection of carotid artery stenosis. Stroke11:27-30, 1980.
5.
Capistrant TD , Gumnit RJ: Thermography and extra-cranial cerebrovascular disease, preliminary report of a new provocative technique. Arch Neurol22:499-503, 1970.
Mawdsley C., Samuel E., Sumerling N., et al: Thermography in occlusive cerebrovascular disease. Br Med J3:521-524, 1968.
8.
Chudecek Z.: Contribution to the causes of false negative thermographic findings in the occlusions of the internal carotid artery. Acta Thermograph4:111, 1979.
9.
Pochaczevsky R., Wexler CE, Meyers PH, et al: Liquid crystal thermography of the spine and extremities. J Neurosurg56:386-395, 1982.
10.
Jenkins G., Chiappa K., Young R.: Practical aspects of EEG monitoring during carotid endarterectomies. Am J EEG Technol23:191-203, 1983.
11.
Chiappa K., Burke S., Young R.: Results of electroencephalographic monitoring during 367 carotid endarterectomies . Stroke10:381-388, 1979.
12.
Ferguson G. : Intraoperative monitoring and internal shunts: Are they necessary in carotid endarterectomy?Stroke13:287-289,1982.
13.
Baker J., et al: An evaluation of electrographic monitoring for carotid study . Surgery78:787-794, 1975.
