Cognitive functions in late periods after reconstructive operations on the carotid arteries

Abstract

Objective: to study changes in cognitive function (CF) in patients after reconstructive operations on the carotid arteries and their association with the development of postoperative asymptomatic focal cerebral ischemic changes. Subjects and methods. Eighty-four patients (6' males and 23 females; mean age 62±8 years) with carotid artery occlusion were examined before and different periods (3, 6, and 9 months) after reconstructive operations on the carotid arteries. Various neuropsychological tests were used; cognitive evoked potentials (P300) were examined. Diffusion-weighed magnetic resonance imaging revealed postoperative cerebral ischemic changes in 27 (32%) patients on days 1-2. Results and discussion. As compared to the baseline data, there was an increase in the total MMSE score at 6-9 months. Tests estimating different memory modalities and attention revealed differently directed changes: improved direct reproduction and slightly deteriorated thinking, as shown by a test of directed (categorical) associations. No substantial CF changes occurred in the majority of patients. There were no significant differences in neuropsychological testing results between patients in accordance with the development of asymptomatic postoperative cerebral ischemic foci; however, when the latter were absent, there was a reduction in P300 latency at 3 and 6 months, which was associated with improved MMSE scores. Conclusion. In late periods after reconstructive operations on the carotid arteries for their occlusive lesion, estimates may vary with used neuropsychological procedures. The development of postoperative asymptomatic cerebral ischemic foci is unassociated with additional CF impairment.

Keywords

• carotid revascularization
• cognitive functions