2011
Cognitive outcome after EC-IC bypass surgery in hemodynamic cerebral ischemia
FIEDLER, Jiří; Vladimír PŘIBÁŇ; Ondřej ŠKODA; Ivo SCHENK; Věra SCHENKOVÁ et al.Základní údaje
Originální název
Cognitive outcome after EC-IC bypass surgery in hemodynamic cerebral ischemia
Autoři
FIEDLER, Jiří; Vladimír PŘIBÁŇ; Ondřej ŠKODA; Ivo SCHENK; Věra SCHENKOVÁ a Simona POLÁKOVÁ
Vydání
Acta Neurichirurgica, Wien, Springer, 2011, 0001-6268
Další údaje
Jazyk
angličtina
Typ výsledku
Článek v odborném periodiku
Obor
30000 3. Medical and Health Sciences
Stát vydavatele
Rakousko
Utajení
není předmětem státního či obchodního tajemství
Impakt faktor
Impact factor: 1.520
Označené pro přenos do RIV
Ano
Kód RIV
RIV/00216224:14110/11:00081790
Organizační jednotka
Lékařská fakulta
UT WoS
Klíčová slova anglicky
Carotid arteries; Cerebral revascularization; Cognition; Brain ischemia; EC-IC bypass
Příznaky
Mezinárodní význam, Recenzováno
Změněno: 20. 10. 2015 10:20, Ing. Mgr. Věra Pospíšilíková
Anotace
V originále
Objective The purpose of this study was to evaluate cognitive functions in patients undergoing extracranial-intracranial (EC-IC) bypass surgery for cerebral ischemia. Population and methods From August 2003 to January 2009, 276 patients with occluded internal carotid arteries (ICA) were screened. Forty of these met the criteria for a low-flow EC-IC bypass. These patients were identified based on evidence of exhausted vasomotor reactivity (VMR) using the Doppler CO(2) test and CT perfusion. These patients were invited to have a complete battery of neuropsychological tests preoperatively and 12 months after surgery. Complete neurocognitive testing was finished in 20 patients. Results This group of 20 patients showed preoperative cognitive impairment ranging from mild to medium-severe. There were no cases of stroke ipsilateral to the operated side during the follow-up period. VMR improvement was seen in all patients within 6 months of surgery. A comparison using a paired t-test demonstrated significant improvement 12 months after surgery in the following neuropsychological tests: WAIS-R (p = 0.01), Number Collection Test (p = 0.02), Trail Making Test (p = 0.03), and Benton Visual Retention Test (p = 0.05). Repeat analysis of variance (ANOVA) suggested the following predictors associated with cognitive improvement:the presence of ophthalmic collateral flow (p = 0.04), preoperative amaurosis fugax (p = 0.02), and external watershed infarction detected by MRI (p = 0.04). Conclusion Patients with occlusion of the ICA and exhausted VMR have cognitive impairment prior to EC-IC bypass surgery. Twelve months after surgery, there is significant improvement in various areas of cognition.