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Left cerebral hemi-neglect following carotid TEA: diagnostic, pathogenetic and therapeutic considerations
E S Debus1, W Müllges, M A Sailer
1Department of Surgery, University of Würzburg, Germany.
Objective:
This paper describes the first case report in the literature of a hemi-neglect following carotid desobliteration. The disorder is explained in detail and diagnostic as well as pathogenetic aspects are discussed in depth.
Subject:
Hemi-neglect syndrome is thought to be a rare complication after carotid-desobliteration. It describes a neuropsychological disorder which can affect motor, sensory and visual modalities, either singly or in combination. The diagnostic approach is rather simple but requires thorough clinical assessment. It can be caused by embolic or hemodynamic reasons; the clinical findings in either case are highlighted and discussed in detail.
Conclusions:
Pre-operative diagnostic evaluation and perioperative management of patients with ICA-stenosis should be undertaken in close co-operation between surgeons and neurologists. This way, the risk of developing neurological complications (i.e. neglect) after surgery can be estimated in the individual case. In high risk cases, indication for surgery should be seen critically.