Wilson David A. author Columbia University. Neurological Surgery Mocco J. author Columbia University. Neurological Surgery D'Ambrosio Anthony L. author Columbia University. Neurological Surgery Komotar Ricardo J. author Columbia University. Neurological Surgery Zurica Joseph author Columbia University. Anesthesiology Kellner Christopher author Columbia University. Neurological Surgery Hahn David K. author Columbia University. Neurological Surgery Connolly Edward S. author Columbia University. Neurological Surgery Liu Sheena Xin author Columbia University. Biomedical Informatics Imielinska Celina Z. author Columbia University. Radiation Oncology Heyer Eric J. author Columbia University. Anesthesiology Columbia University. Neurology Columbia University. Radiation Oncology originator text Articles 2008 English 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. Medical imaging and radiology Neurosciences 30 3 302 306 2008-04 http://dx.doi.org/10.1179/016164107X230540 http://hdl.handle.net/10022/AC:P:14353 NNC NNC 2012-08-13 12:55:41 -0400 2012-08-13 13:22:15 -0400 8372 eng