Cognitive improvement after extracranial reconstruction for the low flow--endangered brain.

Twelve patients with multiple occlusive neck vessel lesions were thought to possess low flow-endangered brains. These patients were studied before and after carotid reconstruction with a battery of neuropsychologic tests emphasizing memory and mental agility. A closely matched control group was selected from patients undergoing endarterectomy for hemodynamically insignificant lesions. The patients with low flow-endangered brains showed significantly greater improvements in memory and mental abilities than did the control group. Reconstruction of neck vessels may reverse such global neurologic deficits in carefully selected patients.