J 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

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.