Left or right carotid endarterectomy in patients with atherosclerotic disease: ipsilateral effects on cognition?
We evaluated hemispheric functions ipsilateral to the side of carotid endarterectomy (CEA) in patients with a severe stenosis in the left or right carotid artery. Assessments took place 1 day before and 3 months after CEA. Only right-handed males were included. Nineteen patients underwent surgery of the left carotid artery and 17 of the right. Valid instruments for hemispheric function were included, such as verbal dichotic listening, finger tapping, and a lateralised test for motor planning. Results showed that, preoperatively, patients had lower scores compared to norms on the laterality tests, and on a visuoconstructive test. There was no evidence of ipsilateral improvement related to side of surgery. Left ear dichotic listening improved, which was seen in both left and right surgery groups. Also in both groups, left- and right-hand movement speed in the motor planning test decreased. Conclusion is that beneficial ipsilateral cognitive change after CEA in patients with severe stenosis in one of the carotid arteries may not be demonstrated, even if valid instruments for hemispheric function are included.
Department of Health Psychology, Research Institute for Psychology and Health, Utrecht University, Utrecht TC, The Netherlands. n.brand@fss.uu.nl
N
N
Brand
E R
ER
Bossema
M van
Mv
Ommen Mv
F L
FL
Moll
R G A
RG
Ackerstaff
D000368:Aged; D001921:Brain / Q000098:blood supply* / Q000601:surgery*; D016893:Carotid Stenosis / Q000601:surgery*; D003072:Cognition Disorders / Q000175:diagnosis*; D004007:Dichotic Listening Tests; D016894:Endarterectomy, Carotid / Q000379:methods*; D005500:Follow-Up Studies; D007839:Functional Laterality; D006801:Humans; D002537:Intracranial Arteriosclerosis / Q000601:surgery*; D008297:Male; D008875:Middle Aged; D009483:Neuropsychological Tests; D011182:Postoperative Care; D011300:Preoperative Care; D012720:Severity of Illness Index