Please use this identifier to cite or link to this item: https://doi.org/10.1016/j.jns.2012.07.034
Title: Changes in cerebral hemodynamic and cognitive parameters after external carotid-internal carotid bypass surgery in patients with severe steno-occlusive disease: A pilot study
Authors: Dong, Y. 
Teoh, H.L. 
Chan, B.P.L.
Ning, C.
Yeo, T.T.
Sinha, A.K. 
Venketasubramanian, N. 
Slavin, M.J.
Sachdev, P.
Collinson, S.L. 
Chen, C. 
Sharma, V.K. 
Keywords: Cerebral hemodynamics
Cognition
External carotid-internal carotid (EC/IC) bypass surgery
Intracranial stenosis
SPECT
Transcranial Doppler
Issue Date: 15-Nov-2012
Source: Dong, Y., Teoh, H.L., Chan, B.P.L., Ning, C., Yeo, T.T., Sinha, A.K., Venketasubramanian, N., Slavin, M.J., Sachdev, P., Collinson, S.L., Chen, C., Sharma, V.K. (2012-11-15). Changes in cerebral hemodynamic and cognitive parameters after external carotid-internal carotid bypass surgery in patients with severe steno-occlusive disease: A pilot study. Journal of the Neurological Sciences 322 (1-2) : 112-116. ScholarBank@NUS Repository. https://doi.org/10.1016/j.jns.2012.07.034
Abstract: Background: The direct impact of external carotid-internal carotid (EC-IC) bypass surgery on cognition of patients with severe steno-occlusive disease of internal carotid (ICA) or middle cerebral artery (MCA) is unknown. In this pilot study, we evaluated changes in cerebral hemodynamic and cognition in these patients. Methods: Patients with severe steno-occlusive disease and impaired cerebral vasodilatory reserve (CVR) with transcranial Doppler (TCD) breath holding index (BHI) and acetazolamide-challenged HMPAO-Single Photon Emission Tomographic (SPECT) imaging were offered EC-IC bypass surgery. CVR and cognitive performance using a formal neuropsychological battery were evaluated before and 3-6 months after surgery. Results: Nine patients and 9 matched controls were recruited. Significant CVR improvement from TCD-BHI [median 0 (Inter-quartile range IQR 0.45) to 1.10 (IQR 0.73), p < 0.001] and SPECT (p < 0.001) was observed in surgery patients. EC-IC bypass patients had significant improvement in verbal memory (p = 0.037) and executive function (p = 0.043) and a trend of improvement in visual memory (p = 0.052) compared to controls. Conclusion: EC-IC bypass surgery in carefully selected patients could improve cerebral hemodynamics and verbal memory and executive function. © 2012 Elsevier B.V.
Source Title: Journal of the Neurological Sciences
URI: http://scholarbank.nus.edu.sg/handle/10635/49981
ISSN: 0022510X
DOI: 10.1016/j.jns.2012.07.034
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