NDLI: The effect of carotid endarterectomy on cerebral blood flow and cognitive function.

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The effect of carotid endarterectomy on cerebral blood flow and cognitive function.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Ghogawala, Zoher Amin-Hanjani, Sepideh Curran, Jill Ciarleglio, Maria Berenstein, Alejandro Stabile, Lauren Westerveld, Michael
Description	Author Affiliation: Ghogawala Z ( Wallace Trials Center, Greenwich Hospital, Greenwich, Connecticut)
Abstract	BACKGROUND: The effect of carotid endarterectomy on cognitive function is not fully understood. This study aims to characterize changes in cerebral blood flow after carotid endarterectomy and to determine if patients with improvement in cerebral blood flow have improved cognitive function after endarterectomy. METHODS: Cerebral blood flow was measured preoperatively and 1 month postoperatively using phase contrast magnetic resonance angiography. Preoperative flow impairment was defined as ipsilateral flow at least 20% less than contralateral flow. Improvement in flow was defined as an absolute increase of at least 0.10 in flow ratio from pre- to postoperative assessments. Patients underwent cognitive testing preoperatively and at 1, 6, and 12 months postoperatively. RESULTS: Twenty-four patients with unilateral carotid stenosis were enrolled from 3 sites. Preoperative internal carotid artery (ICA) and middle cerebral artery (MCA) flow impairment was observed in 50% and 22% of patients, respectively. Patients with preoperative flow impairment had an average of 0.25 and 0.16 absolute improvement in flow ratio in the ICA and MCA vessels, respectively; this was statistically significant for patients with baseline ICA flow impairment (P < .01). One hundred percent of patients with improvement in MCA flow had a significant improvement in attention compared to 56% of patients without MCA flow improvement (P = .06). Clinically significant improvements in all 4 cognitive domains were observed at 1 year (P < .01). CONCLUSIONS: Patients with baseline impairment of MCA blood flow were more likely to experience improvement in flow after revascularization. Improvement in MCA blood flow was associated with greater cognitive improvement in attention and executive functioning.
File Format	HTM / HTML
ISSN	10523057
Issue Number	7
Volume Number	22
e-ISSN	15328511
Journal	Journal of Stroke and Cerebrovascular Diseases
Language	English
Publisher	Elsevier
Publisher Date	2013-10-01
Publisher Place	United States
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Research Support, Non-u.s. Gov't Psychology Humans Middle Aged Magnetic Resonance Angiography Male Cerebrovascular Circulation Cognition Aged, 80 And Over Journal Article Physiopathology Neuropsychological Tests Endarterectomy, Carotid Discipline Cardiology Surgery Female Carotid Stenosis Physiology Aged
Content Type	Text
Resource Type	Article
Subject	Rehabilitation Neurology (clinical) Surgery Cardiology and Cardiovascular Medicine

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