Neuropsychological changes following carotid endarterectomy.

Fifty-five subjects undergoing carotid endarterectomy were grouped according to side of operation, i.e. right, left and bilateral. There subjects were administered a comprehensive neuropsychological battery prior to and six months following surgery. The performance of these subjects was compared with a control group undergoing surgical procedures that did not involve the brain or cerebral vasculature, and a second control group composed of patients with cerebrovascular symptoms who were not operated. It was found that as a group the endarterectomy subjects improved on a greater percentage of measures. When various subgroups were examined, it was found that the right operated stroke patients improved on significantly more measures than any other group. The difference between right and left stroke patients was significant, but there was no difference between right and left TIA patients in the extent of improvement. These findings were discussed in terms of possible underlying mechanisms.