Neuropsychologic function in chronic carotid obstructive disease.
OBJECTIVE
The goal of this study was to investigate the factors affecting neuropsychologic function in patients with high-grade stenosis or occlusion of the internal carotid (IC) artery system.


METHODS
The study included 52 patients with over 70% stenosis or obstruction of the cervical IC artery or obstruction of the intracranial IC artery, whose physical ability had recovered to Rankin disability scale 2 or above. The mean duration from the last ischemic attack to assessment was 41 weeks. Neuropsychologic function was measured by Wechsler Adult Intelligence Scale (WAIS) in the 52 patients. The neuropsychologic function was analyzed concerning disease duration; side of carotid lesion; side, number, or size of cerebral infarction; and cerebral circulation.


RESULTS
No significant difference in WAIS IQs of the patients was observed when the patients were stratified by side of cerebral infarction, side of carotid lesion, or duration from the last attack to WAIS assessment. The performance IQ was significantly higher in the group without infarction than in the group with single, small lesions, or the group with multiple or large lesions. The group with normal cerebral circulation had the highest mean full scale IQ, and the group showing misery perfusion showed the widest distribution of IQ values. The group showing matched low perfusion had a significantly lower full-scale IQ than the groups showing normal cerebral blood flow, and consisted of a large proportion of patients with prolonged duration from the last attack to WAIS assessment.


CONCLUSIONS
Patients with IC stenosis or obstruction show various degrees of cerebral circulatory impairment. The neuropsychologic function in these patients is frequently impaired, which is probably caused by a prolonged impaired cerebral circulatory state in addition to ischemic lesions.
Fukuda
T
T
Department of Neurosurgery, Hachiouji Medical Center, Tokyo Medical University, Tokyo, Japan.
Maruno
T
T
Ito
H
H