title: Vascular surgical society of great britain and ireland: impact of spontaneous embolization on cognitive function
abstract: BACKGROUND: Although microembolization may not be associated with focal neurological events following carotid endarterectomy (CEA), it might contribute towards cognitive impairment. METHODS: Forty-nine patients undergoing CEA underwent 30 min of preoperative ipsilateral transcranial Doppler (TCD) monitoring and a battery of tests of cognitive function, and the results were compared with those of age-matched normal controls. RESULTS: Seven patients who were spontaneously embolizing had significantly worse preoperative cognitive function scores than 42 patients with no recorded emboli (P = 0.03). Overall, patients undergoing CEA had a significant cognitive deficit compared with age-matched normal controls. CONCLUSION: Patients who have evidence of spontaneous preoperative embolization on TCD monitoring have a greater degree of preoperative cognitive impairment. This finding underlines the potential clinical importance of microembolization and suggests that this phenomenon should be investigated further.
authors.affiliation: Royal Infirmary, Leicester, UK.
authors.initials: AJ
authors.lastname: Lloyd
authors.initials: JL
authors.lastname: Smith
authors.initials: IM
authors.lastname: Loftus
authors.initials: P
authors.lastname: Hayes
authors.initials: PR
authors.lastname: Bell
authors.initials: AR
authors.lastname: Naylor