Effect of Unilateral Carotid Artery Stenting on Cognitive Function in Patients with Severe Bilateral Stenosis
Mitsutaka Nakahara1, Kouichi Misaki1, Taishi Tsutsui1
1Department of Neurosurgery, Graduate School of Medical Science, Kanazawa University, Kanazawa, Japan.
Insights
Carotid artery stenting (CAS) improved cognitive function in an elderly patient with severe bilateral carotid artery stenosis. The procedure enhanced cerebral blood flow and reversed cognitive decline, demonstrating CAS as a potential treatment for related dementia.
Area of Science:
- Neurology
- Vascular Surgery
- Geriatrics
Background:
- Severe bilateral carotid artery stenosis can lead to cognitive impairment and stroke.
- Reduced cerebral vascular reactivity is a marker of compromised brain perfusion.
Observation:
- An 82-year-old male with dementia and gait disturbance presented with severe bilateral carotid artery stenosis.
- Preoperative assessment revealed reduced cerebral vascular reactivity.
- The patient underwent successful single-stage carotid artery stenting (CAS) for right internal carotid artery stenosis.
Findings:
- Post-CAS, cerebral vascular reactivity significantly increased bilaterally.
- The patient experienced notable improvements in memory, fluency, and attention.
Implications:
- Single-stage CAS may offer a therapeutic benefit for cognitive dysfunction in patients with severe bilateral carotid artery stenosis.
- This case suggests CAS can improve cerebral hemodynamics and cognitive outcomes without inducing hyperperfusion syndrome.
Case Description:
An 82-year-old man with dementia, gait disturbance, and a small cerebral infarction owing to severe bilateral carotid artery stenosis was successfully treated with carotid artery stenting (CAS). Preoperative cerebral vascular reactivity was reduced in the bilateral cerebral hemispheres. We performed CAS to treat right internal carotid artery stenosis. Following CAS, cerebral vascular reactivity showed an increase in the bilateral cerebral hemispheres. Memory, fluency, and attention also showed improvement.
Conclusions:
This case illustrates the potential benefit of single-stage CAS for cognitive function in severe bilateral carotid artery stenosis without hyperperfusion syndrome.
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