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April2011 Vol.48 Issue:        2        Table of Contents
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Assessment of Cognitive Functions in Asymptomatic Carotid Artery Disease

Omar A. El-Serafy1, Foad A. Abd Allah1, Mona AF. Nada1, Waleed A. Ammar2, Mohamed Nasr I. El-Sirafy3, Ahmed A. Imam4, Amany H. Abou Al-Magd1

Departments of Neurology1, Cardiology2, Cairo University; Diagnostic Radiology3,

Alexandria University; National Heart Institute4; Egypt

 



ABSTRACT

Background: Carotid artery disease is an important cause of cognitive impairment in patients with stroke. Detection of a relation between carotid stenosis in asymptomatic subjects and cognitive dysfunction can open new scoop for early treatment. Objective: To assess the relation between cognitive function and asymptomatic carotid disease and to detect the relation between asymptomatic carotid stenosis and brain MRI. Methods: Ten asymptomatic subjects with moderate to severe carotid stenosis and 10 healthy control subjects were included. All subjects were subjected to: complete neurovascular examination, laboratory investigations, carotid and transcranial duplex, MRI brain and cognitive assessment using tests for global and specific cognitive functions. Results: In comparison to the control group, subjects with carotid stenosis had significantly lower levels of performance in tests of memory, language, executive functions, verbal memory and visuospatial functions, independent of MRI lesions. White matter hyperintensities were more prevalent than lacunar infarction in the carotid stenosis group. A statistically significant correlation was found between the degree of carotid stenosis and performance on tests of memory and executive functions. Subjects with bilateral carotid stenosis performed worse than those with unilateral stenosis in attention, memory and executive functions tests. Conclusion: Carotid artery stenosis was associated with poor neuropsychological performance in neurologically asymptomatic subjects. This could not be explained by a higher proportion of silent MRI lesions in asymptomatic subjects, making it less likely caused by silent emboli. [Egypt J Neurol Psychiat Neurosurg.  2011; 48(2): 95-102]

 

Key Words: Asymptomatic carotid artery stenosis, carotid duplex, cognition, MRI brain.

 

 

Correspondence to Mona Abd el Fatah Nada, Department of Neurology, Cairo University.

Tel.: +20189288848. Email: mona_A_nada@yahoo.com





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