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Post-carotid endarterectomy neurocognitive decline is associated with cerebral blood flow asymmetry on post-operative magnetic resonance perfusion brain scans

David A. Wilson; J. Mocco; Anthony L. D'Ambrosio; Ricardo J. Komotar; Joseph Zurica; Christopher Kellner; David K. Hahn; Edward S. Connolly; Sheena Xin Liu; Celina Z. Imielinska; Eric J. Heyer

Title:
Post-carotid endarterectomy neurocognitive decline is associated with cerebral blood flow asymmetry on post-operative magnetic resonance perfusion brain scans
Author(s):
Wilson, David A.
Mocco, J.
D'Ambrosio, Anthony L.
Komotar, Ricardo J.
Zurica, Joseph
Kellner, Christopher
Hahn, David K.
Connolly, Edward S.
Liu, Sheena Xin
Imielinska, Celina Z.
Heyer, Eric J.
Date:
Type:
Articles
Department:
Radiation Oncology
Volume:
30
Permanent URL:
Book/Journal Title:
Neurological Research
Abstract:
Objective: Up to 25% of patients experience subtle declines in post-operative neurocognitive function following, otherwise uncomplicated, carotid endarterectomy (CEA). We sought to determine if post-CEA neurocognitive deficits are associated with cerebral blood flow (CBF) abnormalities on post-operative MR perfusion brain scans. Methods: We enrolled 22 CEA patients to undergo a battery of neuropsychometric tests pre-operatively and on post-operative day 1 (POD 1). Neurocognitive dysfunction was defined as a two standard deviation decline in performance in comparison to a similarly aged control group of lumbar laminectomy patients. All patients received MR perfusion brain scans on POD 1 that were analysed for asymmetries in CBF distribution. One patient experienced a transient ischemic attack within 24 hours before the procedure and was excluded from our analysis. Results: Twenty-nine percent of CEA patients demonstrated neurocognitive dysfunction on POD 1. One hundred percent of those patients with cognitive deficits demonstrated CBF asymmetry, in contrast to only 27% of those patients without cognitive impairment. Post-CEA cognitive dysfunction was significantly associated with CBF abnormalities (RR=3.75, 95% CI: 1.62-8.67, p=0.004). Conclusion: Post-CEA neurocognitive dysfunction is significantly associated with post-operative CBF asymmetry. These results support the hypothesis that post-CEA cognitive impairment is caused by cerebral hemodynamic changes. Further work exploring the relationship between CBF and post-CEA cognitive dysfunction is needed.
Subject(s):
Medical imaging and radiology
Neurosciences
Publisher DOI:
http://dx.doi.org/10.1179/016164107X230540
Item views:
126
Metadata:
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