Cognitive Function After Carotid Endarterectomy: Early Decline and Later Recovery.

Area of Science:

• Neurology
• Vascular Surgery
• Cognitive Science

Background:

• Carotid endarterectomy (CEA) is a common procedure for carotid artery stenosis.
• Neurocognitive outcomes after CEA require further investigation, considering potential confounding factors.

Purpose of the Study:

• To prospectively evaluate neurocognitive performance after CEA.
• To identify factors influencing cognitive changes at different postoperative intervals.

Main Methods:

• 36 patients undergoing CEA (Group A) and 31 controls (Group B) were studied.
• Neuropsychological tests (MMSE, CDT) and brain MRI with DWI were performed preoperatively, 3 days, and 3 months post-surgery.

Main Results:

• No cerebral ischemia was detected by DWI post-CEA.
• Cognitive scores (MMSE, CDT) significantly decreased within 3 days after CEA but returned to baseline by 3 months.
• Higher ICA stenosis degree and clamping duration correlated with immediate postoperative cognitive impairment.

Conclusions:

• CEA is associated with early, transient cognitive decline.
• Cognitive function recovers by 3 months post-CEA.
• Early cognitive impairment may stem from intraoperative hypoperfusion/postoperative hyperperfusion rather than microemboli.