Psychocognitive, biochemical and electrophysiological changes after endarterectomy (reperfusion) in patients with carotid stenosis, cerebral response to reperfusion

Objective: Cerebral blood flow gradually decreases in patients with carotid stenosis. The aim of this study is evaluate the cellular and cognitive processes related to the increased blood flow after the endarteractomy by using EEG, Neurochemical Indicators and Psychocognitive tests, to develop new diagnostic and follow-up methods and to evaluate the effectiveness of these methods. Materials and Methods: In Istanbul Medical Faculty Hospital Cardiovascular Surgery Department 48 patients (58.3% (n = 28) male, 41.7% (n = 20) female) were underwent carotid endarterectomy included in this study. Of these included EEG, 56.7% (n = 17) were male and 30% (43.3% (n = 13) were female). The age of the patients were 8.3% (n = 4), 43-56 years of age, 50% (n = 24) 57-70 years of age and 41.7% of the patients were 71-84 years of age. Biochemical markers, EEG changes and neurocognitive changes before and after carotid endarterectomy in these patients were investigated. Result: As a result of our study, there was no statistically significant difference between the NSE, S100B and GFAP values in the early postoperative period before and after the carotid endarterectomy operation in the early postoperative period, whereas the s100b and GFAP values decreased in the late postoperative period statistically significant, In neurophyscocognitive tests only statistically significant short-term memory, attention-range forward and backward score increased, and stroop test score decreased. EEG analysis of 30 patients revealed improvement in EEG, slow wave frequency and amplitude reduction in 10 patients. Conclusion: In our study, it was determined that the amount of biochemical markers decreased in the late post op period by limiting the inflammation in which the biochemical markers were insignificant in the early postoperative period. In the patient's who'm had no infarction in the MRI after the carotid endarterectomy operation significant improvements in EEG has shown. Significant improvements are reduction in slow wave frequency and amplitude. In neurophyscocognitive tests only short time memory and attention range tests had improved but the correlation of EEG and biochemical markers were biostatistically insignificant. When the EEG and neurophyscocognitive tests were correlated with each other the results was biostatistically insignificant.