PDF(Pubmed)
Abstract：
BACKGROUND: Revascularization techniques in cervical internal carotid artery (ICA) stenosis are indicated to prevent the onset or recurrence of ischemic events in the setting of atherosclerotic carotid artery disease. Recent reports, case series, and comparative studies have suggested that revascularization techniques may also improve cognitive outcome in both symptomatic and asymptomatic patients, thus raising the question of whether another surgically treatable dementia has presented itself.
METHODS: A 70-year-old right-handed female with a history of hypertension, diabetes, and bilateral silent cerebral infarcts was evaluated for progressive cognitive impairment over a 1-year period, which was associated with a severe left cervical ICA stenosis. Carotid endarterectomy (CEA) was indicated as a revascularization technique, and the patient showed significant neurocognitive improvement as early as one month postoperatively, consistent with blood flow restoration to the left hemisphere on control imaging.
CONCLUSIONS: This case serves as a reminder that CEA may improve the cognitive outcome of patients previously impaired by uncomplicated severe cervical ICA atherosclerotic disease, which can be another cause of treatable dementia. Further prospective studies may help to assess this potential benefit.
METHODS: A 70-year-old right-handed female with a history of hypertension, diabetes, and bilateral silent cerebral infarcts was evaluated for progressive cognitive impairment over a 1-year period, which was associated with a severe left cervical ICA stenosis. Carotid endarterectomy (CEA) was indicated as a revascularization technique, and the patient showed significant neurocognitive improvement as early as one month postoperatively, consistent with blood flow restoration to the left hemisphere on control imaging.
CONCLUSIONS: This case serves as a reminder that CEA may improve the cognitive outcome of patients previously impaired by uncomplicated severe cervical ICA atherosclerotic disease, which can be another cause of treatable dementia. Further prospective studies may help to assess this potential benefit.
摘要：
背景：颈内动脉（ICA）狭窄的血运重建技术可预防动脉粥样硬化性颈动脉疾病中缺血性事件的发生或复发。最近的报道，案例系列,和比较研究表明，血运重建技术也可以改善有症状和无症状患者的认知结果，因此提出了另一种可手术治疗的痴呆症是否已经出现的问题。
方法：一位有高血压病史的70岁右撇子女性，糖尿病,评估双侧无症状性脑梗死在1年内的进行性认知障碍，与严重的左宫颈ICA狭窄有关。颈动脉内膜切除术（CEA）被认为是一种血运重建技术，患者早在术后一个月就表现出明显的神经认知改善，与对照成像上左半球的血流恢复一致。
结论：这个案例提醒我们，CEA可以改善先前因无并发症的严重宫颈ICA动脉粥样硬化疾病而受损的患者的认知结果，这可能是可治疗痴呆症的另一个原因。进一步的前瞻性研究可能有助于评估这种潜在的益处。
方法：一位有高血压病史的70岁右撇子女性，糖尿病,评估双侧无症状性脑梗死在1年内的进行性认知障碍，与严重的左宫颈ICA狭窄有关。颈动脉内膜切除术（CEA）被认为是一种血运重建技术，患者早在术后一个月就表现出明显的神经认知改善，与对照成像上左半球的血流恢复一致。
结论：这个案例提醒我们，CEA可以改善先前因无并发症的严重宫颈ICA动脉粥样硬化疾病而受损的患者的认知结果，这可能是可治疗痴呆症的另一个原因。进一步的前瞻性研究可能有助于评估这种潜在的益处。
