Evaluation of Subclinical Cerebral Injury and Neuropsychologic Function in Patients Undergoing Carotid Endarterectomy

Juergen Falkensammer, W. Andrew Oldenburg, Andrea J. Hendrzak, Beate Neuhauser, Otto D Pedraza, Tanis Jill Ferman, Joseph Klocker, Matthias Biebl, Beate Hugl, James F Meschia, Albert Hakaim, Thomas G Brott

Research output: Contribution to journalArticle

20 Citations (Scopus)

Abstract

We examined subclinical alterations of cerebral function during carotid endarterectomy (CEA) and predictability of minor cerebral damage by perioperative levels of biochemical markers of brain damage (S100B and neuron-specific enolase [NSE]). Twenty consecutive patients with ≥70% asymptomatic carotid stenosis undergoing elective CEA were enrolled. Pre- and postoperative testing included magnetic resonance imaging (MRI) of the head, a standardized neurological exam, a battery of neuropsychological tests, and measurement of serum levels of S100B and NSE. There were no major ischemic strokes. In one patient, a mild weakness of the contralateral lower extremity was discovered on neurological examination; in another individual, postoperative MRI revealed two new small subcortical lesions without clinical correlate. While S100B increased significantly early after opening of the carotid clamp (p = 0.015), the NSE increase did not reach statistical significance. As a group, participants obtained a significantly higher mean overall neuropsychological score at follow-up testing (p < 0.05). In one patient, a significant decline of cognitive function was observed. This was the only individual to obtain a consistently high S100B and NSE increase. Neuropsychological testing combined with measurements of S100B and NSE may improve sensitivity when assessing subtle cerebral damage following CEA.

Original languageEnglish (US)
Pages (from-to)497-504
Number of pages8
JournalAnnals of Vascular Surgery
Volume22
Issue number4
DOIs
StatePublished - Jul 2008

Fingerprint

Phosphopyruvate Hydratase
Carotid Endarterectomy
Wounds and Injuries
Magnetic Resonance Imaging
Neuropsychological Tests
Carotid Stenosis
Neurologic Examination
Cognition
Lower Extremity
Biomarkers
Stroke
Head
Brain
Serum

ASJC Scopus subject areas

  • Cardiology and Cardiovascular Medicine

Cite this

Evaluation of Subclinical Cerebral Injury and Neuropsychologic Function in Patients Undergoing Carotid Endarterectomy. / Falkensammer, Juergen; Oldenburg, W. Andrew; Hendrzak, Andrea J.; Neuhauser, Beate; Pedraza, Otto D; Ferman, Tanis Jill; Klocker, Joseph; Biebl, Matthias; Hugl, Beate; Meschia, James F; Hakaim, Albert; Brott, Thomas G.

In: Annals of Vascular Surgery, Vol. 22, No. 4, 07.2008, p. 497-504.

Research output: Contribution to journalArticle

Falkensammer, Juergen ; Oldenburg, W. Andrew ; Hendrzak, Andrea J. ; Neuhauser, Beate ; Pedraza, Otto D ; Ferman, Tanis Jill ; Klocker, Joseph ; Biebl, Matthias ; Hugl, Beate ; Meschia, James F ; Hakaim, Albert ; Brott, Thomas G. / Evaluation of Subclinical Cerebral Injury and Neuropsychologic Function in Patients Undergoing Carotid Endarterectomy. In: Annals of Vascular Surgery. 2008 ; Vol. 22, No. 4. pp. 497-504.
@article{fbeb9796eefe4f8abfb6bd379982c194,
title = "Evaluation of Subclinical Cerebral Injury and Neuropsychologic Function in Patients Undergoing Carotid Endarterectomy",
abstract = "We examined subclinical alterations of cerebral function during carotid endarterectomy (CEA) and predictability of minor cerebral damage by perioperative levels of biochemical markers of brain damage (S100B and neuron-specific enolase [NSE]). Twenty consecutive patients with ≥70{\%} asymptomatic carotid stenosis undergoing elective CEA were enrolled. Pre- and postoperative testing included magnetic resonance imaging (MRI) of the head, a standardized neurological exam, a battery of neuropsychological tests, and measurement of serum levels of S100B and NSE. There were no major ischemic strokes. In one patient, a mild weakness of the contralateral lower extremity was discovered on neurological examination; in another individual, postoperative MRI revealed two new small subcortical lesions without clinical correlate. While S100B increased significantly early after opening of the carotid clamp (p = 0.015), the NSE increase did not reach statistical significance. As a group, participants obtained a significantly higher mean overall neuropsychological score at follow-up testing (p < 0.05). In one patient, a significant decline of cognitive function was observed. This was the only individual to obtain a consistently high S100B and NSE increase. Neuropsychological testing combined with measurements of S100B and NSE may improve sensitivity when assessing subtle cerebral damage following CEA.",
author = "Juergen Falkensammer and Oldenburg, {W. Andrew} and Hendrzak, {Andrea J.} and Beate Neuhauser and Pedraza, {Otto D} and Ferman, {Tanis Jill} and Joseph Klocker and Matthias Biebl and Beate Hugl and Meschia, {James F} and Albert Hakaim and Brott, {Thomas G}",
year = "2008",
month = "7",
doi = "10.1016/j.avsg.2008.01.013",
language = "English (US)",
volume = "22",
pages = "497--504",
journal = "Annals of Vascular Surgery",
issn = "0890-5096",
publisher = "Elsevier Inc.",
number = "4",

}

TY - JOUR

T1 - Evaluation of Subclinical Cerebral Injury and Neuropsychologic Function in Patients Undergoing Carotid Endarterectomy

AU - Falkensammer, Juergen

AU - Oldenburg, W. Andrew

AU - Hendrzak, Andrea J.

AU - Neuhauser, Beate

AU - Pedraza, Otto D

AU - Ferman, Tanis Jill

AU - Klocker, Joseph

AU - Biebl, Matthias

AU - Hugl, Beate

AU - Meschia, James F

AU - Hakaim, Albert

AU - Brott, Thomas G

PY - 2008/7

Y1 - 2008/7

N2 - We examined subclinical alterations of cerebral function during carotid endarterectomy (CEA) and predictability of minor cerebral damage by perioperative levels of biochemical markers of brain damage (S100B and neuron-specific enolase [NSE]). Twenty consecutive patients with ≥70% asymptomatic carotid stenosis undergoing elective CEA were enrolled. Pre- and postoperative testing included magnetic resonance imaging (MRI) of the head, a standardized neurological exam, a battery of neuropsychological tests, and measurement of serum levels of S100B and NSE. There were no major ischemic strokes. In one patient, a mild weakness of the contralateral lower extremity was discovered on neurological examination; in another individual, postoperative MRI revealed two new small subcortical lesions without clinical correlate. While S100B increased significantly early after opening of the carotid clamp (p = 0.015), the NSE increase did not reach statistical significance. As a group, participants obtained a significantly higher mean overall neuropsychological score at follow-up testing (p < 0.05). In one patient, a significant decline of cognitive function was observed. This was the only individual to obtain a consistently high S100B and NSE increase. Neuropsychological testing combined with measurements of S100B and NSE may improve sensitivity when assessing subtle cerebral damage following CEA.

AB - We examined subclinical alterations of cerebral function during carotid endarterectomy (CEA) and predictability of minor cerebral damage by perioperative levels of biochemical markers of brain damage (S100B and neuron-specific enolase [NSE]). Twenty consecutive patients with ≥70% asymptomatic carotid stenosis undergoing elective CEA were enrolled. Pre- and postoperative testing included magnetic resonance imaging (MRI) of the head, a standardized neurological exam, a battery of neuropsychological tests, and measurement of serum levels of S100B and NSE. There were no major ischemic strokes. In one patient, a mild weakness of the contralateral lower extremity was discovered on neurological examination; in another individual, postoperative MRI revealed two new small subcortical lesions without clinical correlate. While S100B increased significantly early after opening of the carotid clamp (p = 0.015), the NSE increase did not reach statistical significance. As a group, participants obtained a significantly higher mean overall neuropsychological score at follow-up testing (p < 0.05). In one patient, a significant decline of cognitive function was observed. This was the only individual to obtain a consistently high S100B and NSE increase. Neuropsychological testing combined with measurements of S100B and NSE may improve sensitivity when assessing subtle cerebral damage following CEA.

UR - http://www.scopus.com/inward/record.url?scp=46649102831&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=46649102831&partnerID=8YFLogxK

U2 - 10.1016/j.avsg.2008.01.013

DO - 10.1016/j.avsg.2008.01.013

M3 - Article

C2 - 18504102

AN - SCOPUS:46649102831

VL - 22

SP - 497

EP - 504

JO - Annals of Vascular Surgery

JF - Annals of Vascular Surgery

SN - 0890-5096

IS - 4

ER -