The neurologic exam is a sensitive, qualitative technique to assess adequacy of cerebral blood flow during cerebrovascular procedures. The primary limitation is that the patient must be awake during the procedure. For carotid endarterectomy, this generally poses no major difficulties. Using a cervical ganglion block, the procedure is performed with ongoing neurologic and language examination. Since an awake carotid endarterectomy obviates the need for EEG monitoring and allows the patient to be discharged within 24 hours, there is a clear benefit in cost. Furthermore, it is likely that cardiac complications are reduced using regional anesthesia as compared to general anesthesia for carotid endarterectomy. Some patients, however, will not tolerate undergoing an awake procedure.
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The term vaginitis is one that is applied to any inflammation or infection of the vagina, and there are many different conditions that are categorized together under this ‘broad’ heading, including bacterial vaginosis, trichomoniasis and non-infectious vaginitis.