BACKGROUND: The mechanisms underlying post-extracranial to intracranial (EC-IC) bypass neurocognitive changes are poorly understood. METHODS: Data from 55 @entity1 who underwent a unilateral EC-IC bypass for @entity2998 (ICA)/middle cerebral artery (MCA) steno-occlusive disease were retrospectively evaluated. These @entity1 underwent neuropsychological examinations (NPEs), including assessment by the Wechsler Adult Intelligence Scale-Third Edition and Wechsler Memory Scale-Revised (WMS-R) before and 6  months after EC-IC bypass. Results of NPEs were converted into Z-scores from which preoperative cognitive composite scores (CSpre) and postoperative cognitive composite scores (CSpost) were obtained. The association between the change of composite score between pre- and postoperative NPEs (CSpost-pre   =   CS post - CS pre) and various variables were assessed. These latter variables included occluded artery (ICA or MCA), preexisting @entity2806 as verified in preoperative T2WI, robust bypass patency as verified by MRA performed approximately 6  months postoperatively, and postoperative transient @entity16 and/or @entity282 ( @entity6087 ), both of which were dichotomized as postoperative events. RESULTS: Postoperative MRI follow-up (median, 6  months; interquartile range, 5-8 months) confirmed successful bypasses in all @entity1 , with no additional ischemic lesions on T2WI when compared with preoperative imaging. Further, MRA showed patent bypasses in all @entity1 . A nearly statistically significant CS post-pre decrease was observed in @entity1 with postoperative events when compared with those without postoperative events (-0.158 vs. 0.039; p   =   0.069). A multiple regression model predicting CSpost-pre was performed. After controlling for occluded arteries, postoperative events were identified as an independent predictor of a decline in CSpost-pre (p   =   0.044). In the group rate analysis, three of four postoperative NPE scores (Performance IQ, @entity3297 ) were significantly improved relative to preoperative NPE scores. CONCLUSIONS: Postoperative transient @entity16 and/or @entity6087 might play a significant role in the subtle decline in cognition following an EC-IC bypass. However, this detrimental effect was small, and based on the group rate analysis, we concluded that a successful unilateral EC-IC bypass does not adversely affect postoperative cognitive function.

Postoperative transient @entity16 and XXXX after extracranial-intracranial bypass for internal carotid/middle cerebral atherosclerotic steno-occlusive diseases: negative effect on cognitive performance.

@entity1 :: ('9606', 'Species') :: ['patients'] @entity2806 :: ('MESH:D002545', 'Disease') :: ['ischemic lesion'] @entity16 :: ('MESH:D009422', 'Disease') :: ['neurological symptoms'] @entity2998 :: ('MESH:D002340', 'Disease') :: ['atherosclerotic internal carotid artery'] @entity6087 :: ('MESH:D020200', 'Disease') :: ['CSDH'] @entity3297 :: ('MESH:D018980', 'Disease') :: ['WMS-memory, WMS-attention'] @entity282 :: ('MESH:D010149', 'Disease') :: ['postoperative chronic subdural hematoma']
@entity6087 :: (MESH:D020200,Disease) :: ['chronic subdural hematoma']
