OBJECTIVE: Carotid endarterectomy (CEA) is an effective means of stroke prevention among appropriately selected patients; however, neuropsychometric testing has revealed subtle cognitive injuries in the early postoperative period. The purpose of this study was to establish whether serum levels of two biochemical markers of cerebral injury were correlated with postoperative declines in neuropsychometric test performance after CEA. METHODS: Fifty-five consecutive patients underwent a battery of neuropsychometric tests 24 hours before and 24 hours after elective CEA. Two patients were excluded because of postoperative strokes. The pre- and postoperative serum levels of S100B protein and neuron-specific enolase for injured patients, defined as those who exhibited significant declines in neuropsychometric test performance (n = 12), were compared with the levels for uninjured patients (n = 41). RESULTS: There were no significant differences in the baseline S100B levels for the two groups. Injured patients exhibited significantly higher S100B levels, compared with uninjured patients, at 24, 48, and 72 hours after surgery (P < 0.05). There were no significant differences in neuron-specific enolase levels for injured and uninjured patients at any time point. CONCLUSION: These data suggest that subtle cerebral injuries after CEA, even in the absence of overt strokes, are associated with significant increases in serum S100B but not neuron-specific enolase levels. Analyses of earlier time points in future studies of subtle cognitive injuries and biochemical markers of cerebral injury after CEA may be revealing.
OBJECTIVE: Carotid endarterectomy (CEA) is an effective means of stroke prevention among appropriately selected patients; however, neuropsychometric testing has revealed subtle cognitive injuries in the early postoperative period. The purpose of this study was to establish whether serum levels of two biochemical markers of cerebral injury were correlated with postoperative declines in neuropsychometric test performance after CEA. METHODS: Fifty-five consecutive patients underwent a battery of neuropsychometric tests 24 hours before and 24 hours after elective CEA. Two patients were excluded because of postoperative strokes. The pre- and postoperative serum levels of S100B protein and neuron-specific enolase for injured patients, defined as those who exhibited significant declines in neuropsychometric test performance (n = 12), were compared with the levels for uninjured patients (n = 41). RESULTS: There were no significant differences in the baseline S100B levels for the two groups. Injured patients exhibited significantly higher S100B levels, compared with uninjured patients, at 24, 48, and 72 hours after surgery (P < 0.05). There were no significant differences in neuron-specific enolase levels for injured and uninjured patients at any time point. CONCLUSION: These data suggest that subtle cerebral injuries after CEA, even in the absence of overt strokes, are associated with significant increases in serum S100B but not neuron-specific enolase levels. Analyses of earlier time points in future studies of subtle cognitive injuries and biochemical markers of cerebral injury after CEA may be revealing.
Authors: E J Heyer; R Sharma; C J Winfree; J Mocco; D J McMahon; P A McCormick; D O Quest; J G McMurtry; C J Riedel; R M Lazar; Y Stern; E S Connolly Journal: J Clin Exp Neuropsychol Date: 2000-10 Impact factor: 2.475
Authors: H G Hårdemark; N Ericsson; Z Kotwica; G Rundström; I Mendel-Hartvig; Y Olsson; S Påhlman; L Persson Journal: J Neurosurg Date: 1989-11 Impact factor: 5.115
Authors: L Persson; H G Hårdemark; J Gustafsson; G Rundström; I Mendel-Hartvig; T Esscher; S Påhlman Journal: Stroke Date: 1987 Sep-Oct Impact factor: 7.914
Authors: J Mocco; David A Wilson; Ricardo J Komotar; Joseph Zurica; William J Mack; Hadi J Halazun; Raheleh Hatami; Robert R Sciacca; E Sander Connolly; Eric J Heyer Journal: Neurosurgery Date: 2006-05 Impact factor: 4.654
Authors: J Mocco; David A Wilson; Andrew F Ducruet; Ricardo J Komotar; William J Mack; Joseph Zurica; Robert R Sciacca; Eric J Heyer; E Sander Connolly Journal: Stroke Date: 2005-12-01 Impact factor: 7.914
Authors: E J Heyer; D A Wilson; D H Sahlein; J Mocco; S C Williams; R Sciacca; A Rampersad; R J Komotar; J Zurica; A Benvenisty; D O Quest; G Todd; R A Solomon; E S Connolly Journal: Neurology Date: 2005-10-05 Impact factor: 9.910
Authors: Eric J Heyer; Joanna L Mergeche; Zirka H Anastasian; Minjae Kim; Kaitlin A Mallon; E Sander Connolly Journal: Neurosurgery Date: 2014-03 Impact factor: 4.654
Authors: David A Wilson; J Mocco; Anthony L D'Ambrosio; Ricardo J Komotar; Joseph Zurica; Christopher P Kellner; David K Hahn; E Sander Connolly; X Liu; Celina Imielinska; Eric J Heyer Journal: Neurol Res Date: 2007-09-04 Impact factor: 2.448
Authors: Eric J Heyer; Joanna L Mergeche; Justin T Ward; Hani R Malone; Christopher Kellner; Samuel S Bruce; E Sander Connolly Journal: Neurosurgery Date: 2013-11 Impact factor: 4.654
Authors: Daniel H Sahlein; Eric J Heyer; Anita Rampersad; Christopher J Winfree; Robert A Solomon; Alan I Benvenisty; Donald O Quest; Evelyn Du; E Sander Connolly Journal: Neurosurgery Date: 2003-12 Impact factor: 4.654