The clinical diagnosis of cranial nerve injuries at operations on the carotid arteries.

Operation on the carotid arteries (CA) prevent strokes in patients with occlusions and stenoses of these arteries. We have worked out the measures for preventing perioperative strokes. During interventions on the CA, iatrogenic injuries to the cranial nerves (CN) are paid little attention. 1186 patients underwent 1362 operations. There were 26 lethal outcomes and 38 strokes. 146 (0.7%) cases of CN injuries were documented. Of these, there were 2 (0.1%) injuries to the accessory nerve, 14 (1%) to the glossopharyngeal nerve, 28 (2%) to the hypoglossal nerve, 46 (3.4%) injuries to vagal nerve branches, and 56 (4.2%) to facial nerve branches. In 42 patients, neuropathies acquired the 'permanent' character. We describe the symptomatology of injuries to different CN pairs consequent on carotid operations and the algorithm of their diagnosis. CN injuries deteriorate the results of operations and decrease quality of life of the patients. Early diagnosis and correction of the sequelae of iatrogenic injuries to the CN is a reserve for the refinement of the results of operations on the CA.