We evaluated hemispheric functions ipsilateral to the side of carotid endarterectomy (CEA) in patients with a severe stenosis in the left or right carotid artery. Assessments took place 1 day before and 3 months after CEA. Only right-handed males were included. Nineteen patients underwent surgery of the left carotid artery and 17 of the right. Valid instruments for hemispheric function were included, such as verbal dichotic listening, finger tapping, and a lateralised test for motor planning. Results showed that, preoperatively, patients had lower scores compared to norms on the laterality tests, and on a visuoconstructive test. There was no evidence of ipsilateral improvement related to side of surgery. Left ear dichotic listening improved, which was seen in both left and right surgery groups. Also in both groups, left- and right-hand movement speed in the motor planning test decreased. Conclusion is that beneficial ipsilateral cognitive change after CEA in patients with severe stenosis in one of the carotid arteries may not be demonstrated, even if valid instruments for hemispheric function are included.
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http://dx.doi.org/10.1016/j.bandc.2003.12.001 | DOI Listing |
Front Cardiovasc Med
January 2025
Pediatric Cardiology, Pediatric Heart Center, Skåne University Hospital, Lund, Sweden.
Background: Recurrent coarctation of the aorta (re-CoA) is a well-known although not fully understood complication after surgical repair, typically occurring in 10%-20% of cases within months after discharge.
Objectives: To (1) characterize geometry of the aortic arch and blood flow from pre-discharge magnetic resonance imaging (MRI) in neonates after CoA repair; and (2) compare these measures between patients that developed re-CoA within 12 months after repair and patients who did not.
Methods: Neonates needing CoA repair, without associated major congenital heart defects, were included.
Front Surg
January 2025
Department of Neurology, Institute of Neuroscience, Key Laboratory of Neurogenetics and Channelopathies of Guangdong Province and the Ministry of Education of China, The Second Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
Background: The primary objective of this study was to estimate the effective cerebral perfusion pressure (CPPe), critical closing pressure (CrCP), and resistance-area product (RAP) of the intravascular common carotid artery using three different methods. These estimates were then compared to the reference method of linear regression (LR).
Methods: In our previous study, we employed linear regression to evaluate the values of CrCP and RAP.
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Kanto Rosai Hospital, Kanagawa, Japan.
Background: The presence of significant tortuosity in access routes to aneurysms can interfere with catheter guidance and manipulation and significantly impact treatment strategies.
Observations: In this report, the authors combined intentional staged aneurysm embolization with the construction of a new direct access route, which they call a "highway bypass," for a symptomatic posterior circulation cerebral aneurysm that was difficult to access with a catheter. Notably, the highway bypass is used for catheter passage, and technical tips should be considered.
J Neurosurg Case Lessons
January 2025
Department of Neurosurgery, Institute of Medicine, University of Tsukuba, Tsukuba, Ibaraki, Japan.
Background: Carotid webs are rare nonatherosclerotic disorders in the carotid artery and are increasingly recognized as factors of ischemic stroke in the young population. Asymptomatic webs can be treated with antithrombotic therapy, whereas symptomatic cases frequently require surgical interventions, including carotid endarterectomy (CEA). However, guidelines for the optimal timing of these treatments remain unestablished, especially compared to atherosclerotic stenotic lesions, due to the rarity of carotid webs.
View Article and Find Full Text PDFIndian J Thorac Cardiovasc Surg
February 2025
Department of Engineering Design, Indian Institute of Technology Madras, Chennai, India.
Purpose: Despite significant improvements in the design and performance of continuous flow left ventricular assist devices (CFLVADs), one of the most important reasons hampering further penetration of this technology is the occurrence of adverse events, especially strokes. One of the well-known risk factors for strokes is hypertension which is particularly common in patients undergoing a CFLVAD implant. While the device is implanted in the heart, strokes happen due to pathology in the brain and we hypothesised that modelling the blood flow in the circle of Willis might shed light on the causation of strokes in this situation.
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