FIEDLER, Jiří, Vladimír PŘIBÁŇ, Ondřej ŠKODA, Ivo SCHENK, Věra SCHENKOVÁ and Simona POLÁKOVÁ. Cognitive outcome after EC-IC bypass surgery in hemodynamic cerebral ischemia. Acta Neurichirurgica. Wien: Springer, 2011, vol. 153, No 6, p. 1303-1312. ISSN 0001-6268. Available from: https://dx.doi.org/10.1007/s00701-011-0949-x.
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Basic information
Original name Cognitive outcome after EC-IC bypass surgery in hemodynamic cerebral ischemia
Authors FIEDLER, Jiří (203 Czech Republic, guarantor, belonging to the institution), Vladimír PŘIBÁŇ (203 Czech Republic, belonging to the institution), Ondřej ŠKODA (203 Czech Republic), Ivo SCHENK (203 Czech Republic), Věra SCHENKOVÁ (203 Czech Republic) and Simona POLÁKOVÁ (203 Czech Republic).
Edition Acta Neurichirurgica, Wien, Springer, 2011, 0001-6268.
Other information
Original language English
Type of outcome Article in a journal
Field of Study 30000 3. Medical and Health Sciences
Country of publisher Austria
Confidentiality degree is not subject to a state or trade secret
Impact factor Impact factor: 1.520
RIV identification code RIV/00216224:14110/11:00081790
Organization unit Faculty of Medicine
Doi http://dx.doi.org/10.1007/s00701-011-0949-x
UT WoS 000290795700021
Keywords in English Carotid arteries; Cerebral revascularization; Cognition; Brain ischemia; EC-IC bypass
Tags International impact, Reviewed
Changed by Changed by: Ing. Mgr. Věra Pospíšilíková, učo 9005. Changed: 20/10/2015 10:20.
Abstract
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.
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