[Dynamics of higher mental functions and complications in the early post-operative phase of carotid endarterectomy].

Authors conducted a clinical-instrumental examination of 97 patients in the post-operative phase of reconstructive surgery of carotid arteries. Evaluation of neurological status, Luria's syndrome neuropsychological analysis for assessment of higher mental functions dynamics (HMF) were carried out. Pre-operative ultrasound duplex scanning of brachio-cephalic arteries and investigation of cerebral perfusion using spiral computed tomography (SCT-perfusion) were done before and 1 day after the surgery. The frequency of intrasurgery stroke in the area of the operated carotid artery was 2.1%. Pre-operative SCT-perfusion revealed the syndrome of cerebral hyperperfusion in 3.1% of patients with higher (>1 s) difference between the average time of blood transition in temporal areas. Dynamics of HMF was the key clinical indicator that allowed to evaluate the course of nearest post-operative phase and to compare it with an area of operated vessel. Changes of HMF were characterized by the decrease in dysfunction of the hemisphere ipsilateral to the side of operation or had differently directed character. The aggravation of HMF disturbances was found in 40% of patients and was represented by syndromes with different topical location. Causes and mechanisms of the development of these changes are discussed.