Effects of sympathectomy of carotid artery on cognitive conditions and brain blood supply in preschool children with cerebral palsy

Abstract

Objective To evaluate the effects of sympathectomy of carotid artery on cognitive conditions and brain blood supply in preschool children with cerebral palsy. Methods A total of 45 preschool children with cerebral palsy were enrolled, they were divided into surgical group and non-surgical group. Twenty-three patients were in surgery group with the mean age of 4.8 years. Twenty-two patients were in non-surgery group with average age of 4.5 years. Two weeks and six months after surgery, the transcranial doppler (TCD) data were collected in surgical group.Meanwhile, the developmental quotient(DQ), intelligence quotient(IQ) and C-factor were also collected in surgery surgical group and non-surgery group. Results In surgery group, the average flow velocity, peak velocity, end-diastolic flow velocity at two weeks after the surgery were significantly greater than those before surgery[before surgery vs 2 weeks after surgery, (87.62±6.12) em/s vs (96.34±7.24)em/s, (134.36±10.26 )em/s vs (149.02±11.23)em/s, (54.55±9.22)em/s vs (60.07±10.24)em/s, all P 0.05). At 6 months after the surgery, the DQ, IQ, C factor in both surgical group and non-surgical group showed significant difference (surgery group vs non-surgery group, 83.40±11.28 vs 61.43±12.72, 80.40±11.28 vs 67.43±12.72, 12.78±3.89 vs 9.99±3.25, all P<0.01). The cognitive index in the surgery group were significant greater than those in non-surgery group. Conclusion Sympathectomy of carotid artery can significantly improve brain blood supply and cognitive development index such as DQ, IQ, C factor in preschool children with cerebral palsy. Key words: Cerebral palsy; Sympathectomy; Carotid artery, common; Transcranial doppler; Cognition; Developmental quotient; Intelligence quotient; C factor