The usefulness of carotid endarterectomy remained unsettled until 1991, although it was one of the most widespread surgical interventions.
Much remains to be done to identify patients at particularly high risk of ipsilateral stroke, for whom carotid endarterectomy may be necessary in addition to medical therapy. Therefore, the most important part of the management of patients with carotid stenosis is optimization of medical therapy. Patients with asymptomatic carotid stenosis have a particularly high risk of cardiac events (about 3.5% per year). Nonstroke vascular events are about twice as likely in patients with carotid bruits compared with those without. There are few data supporting the use of hemodynamic impairment assessment to predict stroke risk. In addition to stenosis severity, carotid plaque composition, which can be evaluated by several noninvasive imaging methods, may be an independent risk factor for stroke. There is a relatively weak relationship between carotid stenosis severity and risk of ipsilateral stroke. The annual risk of ipsilateral ischemic stroke is relatively low, ranging from 1.0 to 3.8% and is about half of that. Although carotid stenosis accounts for about 10% of ischemic strokes, only a minority of patients with carotid stenosis will have a stroke. The prevalence of carotid artery stenosis 50% or greater increases from about 1% in people aged 50 to 59 to about 10% in people older than 70. An analysis of how this relates to structural abnormalities in the brain is planned. There were no significant differences between side of the carotid stenosis and whether the stenosis was symptomatic or asymptomatic.Ĭonclusion: In comparison to normative data borderline cognitive impairment is common in patients with carotid artery stenosis especially within attention/switching tasks. Performance appeared worst in TRAIL making test (Table 2). The majority of participants scored within the average or low average range (Table 1) with 24% scoring as borderline. Results: Thirty-three participants were included: 20 males mean age 70.4 years (range 52–87).
Z scores allow comparison to age matched normative data and performance was described as ranging from ‘very superior’ to ‘profound impairment’.
Test Digit-symbol coding task from the WAIS (III) Centre for Epidemiologic studies-depression Scale Trails part A and B cube copy, clock drawing and orientation subsections of the MoCA).We calculated z scores for the appropriate individual assessments and an average z score for each patient as a measure of global cognitive function. A modified version of the “Hachinski 30-minute battery” was used(Hopkins verbal Learning test, Animal Naming Controlled Word Association Methods: Patients >50 years old with >50% carotid artery stenosis detected on Doppler ultrasonography but who had not had carotid endarterectomy and had no documented cognitive impairment were included.
However, it may have other sequelae such as development of vascular cognitive impairment.Īims: To assess cognitive function in patients with carotid artery stenosis. Introduction: Carotid artery stenosis is a common cause of ischemic stroke.
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