[Dynamics of higher mental functions in surgical therapy of internal carotid artery stenosis]

To reveal typical changes of higher mental functions in patients with atherosclerotic lesion of internal carotid artery and to estimate influence of operative and non-operative treatment of carotid stenosis upon cognitive function. 42 patients who had undergone carotid endarterectomy (CEA) due to high grade carotid stenosis, and 31 patients treated conservatively were examined. A battery of neuropsychological tests was used to evaluate a state of higher mental functions. The neuropsychological syndrome in patients with carotid stenosis manifests with impairment of verbal and visuospatial memory, attention, disorders of impressive speech and constructive praxis. The degree of cognitive impairment was most severe in patients with bilateral stenosis. CEA performed at early stages of cerebral ischaemia has beneficial effect on cognitive functions. Non-operative treatment and late CEA do not prevent further cognitive decline in patients with carotid stenosis.