Academic Commons

Articles

A Controlled Prospective Study of Neuropsychological Dysfunction Following Carotid Endarterectomy

Heyer, Eric J.; Sharma, Ruchey; Rampersad, Anita; Winfree, Christopher J.; Mack, William; Solomon, Robert A.; Todd, George J.; McCormick, Paul C.; McMurtry, James G.; Quest, Donald O.; Stern, Yaakov; Lazar, Ronald M.; Connolly Jr., E. Sander

BACKGROUND: Although subtle cognitive injury as revealed by neuropsychological testing occurs in a substantial number of patients following carotid endarterectomy (CEA), there is controversy about whether this finding is a result of the surgery or the anesthesia. OBJECTIVES: To examine the changes in neuropsychological test performance in patients following CEA vs a control group of patients older than 60 years following spine surgery, so as to determine whether neuropsychological dysfunction after CEA is a result of surgery or anesthesia. METHODS: Patients undergoing CEA (n = 80) and lumbar spine surgery (n = 25) were assessed with a battery of neuropsychological tests preoperatively and on postoperative days 1 and 30. The neuropsychological performance of patients in the control group was used to normalize performance for patients in the CEA group, by calculating z scores using the mean and SD of the change scores in the control group. Significant cognitive dysfunction was defined as performance that exceeded 2 SDs above the mean performance of patients in the control group. RESULTS: Postoperative days 1 and 30 total deficit scores were significantly worse in the CEA group compared with the controls. When individual test results were examined, the CEA group performed significantly worse than the controls on the Rey Complex Figure test and Halstead-Reitan Trails B on day 1, and on the Rey Complex Figure on day 30. Overall, cognitive dysfunction was seen in 22 patients (28%) in the CEA group on day 1 and in 11 (23%) of 48 patients on day 30. CONCLUSIONS: Subtle cognitive decline following CEA occurs and persists for at least several weeks after surgery. This decline was absent in a control group

Files

  • thumnail for Heyer-2002-A Controlled Prospective Study of N.pdf Heyer-2002-A Controlled Prospective Study of N.pdf application/pdf 102 KB Download File

Also Published In

Title
Archives of Neurology
DOI
https://doi.org/10.1001/archneur.59.2.217

More About This Work

Academic Units
Neurology
Published Here
February 22, 2018
Academic Commons provides global access to research and scholarship produced at Columbia University, Barnard College, Teachers College, Union Theological Seminary and Jewish Theological Seminary. Academic Commons is managed by the Columbia University Libraries.