Mononen H, Lepojärvi M, Kallanranta T
Department of Neurology, Oulu University Central Hospital, Finland.
Eur Neurol. 1990;30(6):328-33. doi: 10.1159/000117366.
30 patients with a history of transient ischemic attacks (TIA) and 16 patients with cerebral infarcts were evaluated neuropsychologically 1-3 days before carotid endarterectomy, due to hemodynamically significant carotid artery stenosis, and again 2 weeks and 2 months after operation. Preoperatively, there were no differences between the groups, but postoperatively the neuropsychological outcome of the TIA patients was better than that of the infarction patients. Consequently, carotid endarterectomy patients cannot be studied as one group in neuropsychological examinations but various subgroups should be dealt with separately. In the TIA group 2 months after operation, the patients with left-sided operations had improved in verbal but not in visual tests, and the right-operated patients showed improvement also in visual tests. Therefore, the use of sum scores across neuropsychological tests is not preferable in the evaluation of the effects of carotid endarterectomy because after unilateral operation the cognitive improvement is greater in functions ipsilateral to the operation side.
对30例有短暂性脑缺血发作（TIA）病史的患者和16例脑梗死患者，因其存在血流动力学显著的颈动脉狭窄，在颈动脉内膜切除术术前1 - 3天进行神经心理学评估，并在术后2周和2个月再次评估。术前，两组之间无差异，但术后TIA患者的神经心理学结果优于梗死患者。因此，在神经心理学检查中，不能将颈动脉内膜切除术患者作为一个整体进行研究，而应分别处理不同的亚组。在TIA组术后2个月，接受左侧手术的患者在言语测试中有改善，但视觉测试中未改善，而接受右侧手术的患者在视觉测试中也有改善。因此，在评估颈动脉内膜切除术的效果时，使用神经心理学测试的总分并不合适，因为单侧手术后，手术侧同侧功能的认知改善更大。
