title: Cognitive dysfunction in 16 patients with carotid stenosis: detailed neuropsychological findings.
abstract: BACKGROUND
  Impairment of cognitive function is often present in patients with carotid artery stenosis but the details of this dysfunction have rarely been reported. Our purpose was to elucidate the cognitive dysfunction in patients with unilateral severe carotid stenosis using comprehensive neuropsychological testing, and also to identify the specific underlying clinical and radiological factors.
  
  
  METHODS
  We analyzed the results of neuropsychological testing, the clinical history, and MR findings in 16 consecutive patients with angiographically proven severe (70-99%) stenosis of the extra cranial internal carotid artery (ICA). Cognitive functions were examined using the Seoul Neuropsychological Screening Battery and the Neglect Battery. We excluded patients with cortical infarction and those with contra lateral ICA occlusion or severe stenosis.
  
  
  RESULTS
  Our comprehensive neuropsychological testing revealed obvious cognitive deficits in all patients with unilateral severe ICA stenosis, the most common being frontal executive impairment. The mean cognitive score on the memory test was also significantly lower in patients with symptomatic ICA stenosis than in asymptomatic patients (29.33+/-10.98, mean+/-SD, p < 0.05). The total score on the global cognitive test was significantly lower in patients with an ischemic lesion on MRI than in no lesion patients (113.23+/-34.78, p < 0.05). The presence of symptoms related to the ICA stenosis was related to cognitive dysfunction even when there were no ischemic lesions on MRI. SPECT revealed ipsilateral cortical hypoperfusion in 9 of 12 patients (75%).
  
  
  CONCLUSIONS
  Cognitive deficits are common in patients with unilateral severe ICA stenosis. Our findings suggest that an additional mechanism beyond the structural lesion such as chronic hypoperfusion may affect cognitive function in patients with high-grade ICA stenosis.
authors.affiliation: Department of Neurology, Konyang University College of Medicine, Daejeon, Korea.
authors.forename: Jung Eun
authors.initials: JE
authors.lastname: Kim
authors.forename: Bo Ram
authors.initials: BR
authors.lastname: Lee
authors.forename: Jong Eun
authors.initials: JE
authors.lastname: Chun
authors.forename: Soo Joo
authors.initials: SJ
authors.lastname: Lee
authors.forename: Byung Hee
authors.initials: BH
authors.lastname: Lee
authors.forename: In Kyu
authors.initials: IK
authors.lastname: Yu
authors.forename: Sangyun
authors.initials: S
authors.lastname: Kim