Document Detail


Evaluation of subclinical cerebral injury and neuropsychologic function in patients undergoing carotid endarterectomy.
MedLine Citation:
PMID:  18504102     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
We examined subclinical alterations of cerebral function during carotid endarterectomy (CEA) and predictability of minor cerebral damage by perioperative levels of biochemical markers of brain damage (S100B and neuron-specific enolase [NSE]). Twenty consecutive patients with > or =70% asymptomatic carotid stenosis undergoing elective CEA were enrolled. Pre- and postoperative testing included magnetic resonance imaging (MRI) of the head, a standardized neurological exam, a battery of neuropsychological tests, and measurement of serum levels of S100B and NSE. There were no major ischemic strokes. In one patient, a mild weakness of the contralateral lower extremity was discovered on neurological examination; in another individual, postoperative MRI revealed two new small subcortical lesions without clinical correlate. While S100B increased significantly early after opening of the carotid clamp (p = 0.015), the NSE increase did not reach statistical significance. As a group, participants obtained a significantly higher mean overall neuropsychological score at follow-up testing (p < 0.05). In one patient, a significant decline of cognitive function was observed. This was the only individual to obtain a consistently high S100B and NSE increase. Neuropsychological testing combined with measurements of S100B and NSE may improve sensitivity when assessing subtle cerebral damage following CEA.
Authors:
Juergen Falkensammer; W Andrew Oldenburg; Andrea J Hendrzak; Beate Neuhauser; Otto Pedraza; Tanis Ferman; Joseph Klocker; Matthias Biebl; Beate Hugl; James F Meschia; Albert G Hakaim; Thomas G Brott
Publication Detail:
Type:  Journal Article     Date:  2008-05-27
Journal Detail:
Title:  Annals of vascular surgery     Volume:  22     ISSN:  1615-5947     ISO Abbreviation:  Ann Vasc Surg     Publication Date:    2008 Jul-Aug
Date Detail:
Created Date:  2008-07-14     Completed Date:  2008-09-17     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8703941     Medline TA:  Ann Vasc Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  497-504     Citation Subset:  IM    
Affiliation:
Section of Vascular Surgery, Mayo Clinic Jacksonville, Jacksonville, FL 32224, USA.
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MeSH Terms
Descriptor/Qualifier:
Aged
Aged, 80 and over
Biological Markers / blood
Brain Damage, Chronic / diagnosis,  etiology*
Carotid Stenosis / surgery
Cognition Disorders / diagnosis*,  etiology
Electroencephalography
Endarterectomy, Carotid / adverse effects*
Female
Humans
Male
Middle Aged
Neurologic Examination
Neuropsychological Tests*
Phosphopyruvate Hydratase / blood
S100 Proteins / blood
Chemical
Reg. No./Substance:
0/Biological Markers; 0/S100 Proteins; EC 4.2.1.11/Phosphopyruvate Hydratase

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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