Abstract
The concept that carotid disease may compromise cognitive function was initially proposed by Fisher in 1951, based on an autopsy case. However, some topics involving cognitive function remain controversial, such as its correlation with carotid obstructive disease. So, the authors of this review evaluate the impact of carotid revascularization on cognitive function and the repercussions of the revascularization technique (carotid stenting vs. endarterectomy) chosen. It was clear from the literature reviewed that carotid stenosis is related to a decline in cognitive function over time. However, controversy still remains over the impact of carotid revascularization on cognitive function. With elation to the technique employed (carotid stenting vs. endarterectomy), the majority of studies found no difference between the two techniques in terms of overall cognitive outcome.
Highlights
The concept that carotid disease may compromise cognitive function was initially proposed by Fisher in 1951, based on an autopsy case.[1,2] He postulated that occlusive carotid disease could provoke a state of dementia and proposed restoration of anterograde flow to reverse the condition
On one hand, intervention for carotid stenosis should be beneficial because it restores cerebral blood flow,[2,6] on the other hand, one review has suggested that carotid revascularization leads to a decline in cognitive function because of other mechanisms related to the patients operated and the technique employed.[1]
The literature reviewed makes it clear that carotid stenoses are related to cognitive decline over time
Summary
The concept that carotid disease may compromise cognitive function was initially proposed by Fisher in 1951, based on an autopsy case.[1,2] He postulated that occlusive carotid disease could provoke a state of dementia and proposed restoration of anterograde flow to reverse the condition This insight contributed to the first carotid reconstruction (1951)[1,3] and later to the first carotid endarterectomy (CEA)[1,4,5] in patients who had suffered a stroke and had internal carotid stenosis, which introduced CEA as an important option for stroke management.[1]. Studies suggest that one in three North Americans experience a stroke, dementia or both at some point during their lives,[6,7] and that 64% of individuals who suffer a cerebrovascular event will develop dementia.[6,8] Among the elderly, the risk of dementia increases fourfold after an ischemic stroke.[6,9]
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