Neuropsychometric changes in patients after carotid endarterectomy.

Abstract:

BACKGROUND AND PURPOSE:One hundred twelve patients undergoing elective carotid endarterectomy for symptomatic and asymptomatic carotid artery stenosis were enrolled in a prospective study to evaluate the incidence of change in postoperative cerebral function. METHODS:Patients were evaluated preoperatively and postoperatively before hospital discharge and at follow-up 1 and 5 months later with a battery of neuropsychometric tests. The results were analyzed by both event-rate and group-rate analyses. For event-rate analysis, change was defined as either a decline or improvement in postoperative neuropsychometric performance by 25% or more compared with a preoperative baseline. RESULTS:Approximately 80% of patients showed decline in one or more test scores, and 60% had one or more improved test scores at the first follow-up examination. The percentage of declined test scores decreased and the percentage of improved test scores increased with subsequent follow-up examinations. Group-rate analysis was similar for group performance on individual tests. However, a decline in performance was seen most commonly on verbal memory tests, and improved performance was seen most commonly on executive and motor tests. CONCLUSIONS:Neuropsychometric evaluation of patients undergoing carotid endarterectomy for significant carotid artery stenosis demonstrates both declines and improvements in neuropsychometric performance. The test changes that showed decreased performance may be associated with ischemia from global hypoperfusion or embolic phenomena, and the improvement seen may be related to increased cerebral blood flow from removal of stenosis.

journal_name

Stroke

journal_title

Stroke

authors

Heyer EJ,Adams DC,Solomon RA,Todd GJ,Quest DO,McMahon DJ,Steneck SD,Choudhri TF,Connolly ES

doi

10.1161/01.str.29.6.1110

subject

Has Abstract

pub_date

1998-06-01 00:00:00

pages

1110-5

issue

6

eissn

0039-2499

issn

1524-4628

journal_volume

29

pub_type

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