Cerebral angioplasty in a patient with vascular dementia.

A 66-year-old man with a history of previous transient ischemic attacks had progressive memory and gait disturbance caused by severe stenoses of both the internal carotid arteries and vertebral arteries. The patient underwent percutaneous transluminal angioplasty of the vertebral arteries and endarterectomy of the internal carotid arteries with satisfactory results. On admission, the patient was alert, but disoriented to time and place. He exhibited mild motor weakness in both legs. Neuropsychological tests revealed remarkable intellectual deterioration and he required maximum support to perform activities of daily living. Higher cortical function and the ability to perform activities of daily living improved remarkably after the angioplasty. Angioplasty is an alternative therapy to reverse functional deficits in patients with cerebrovascular hemodynamic compromise.