The presence of carotid atherosclerosis is a potential risk factor for
disorder of cognitive functions. This was demonstrated by studies that
examined the relationship between carotid atherosclerosis and
cognitive disorder. Carotid artery stenosis and thickening of the
intima-media tissue (IMT) reflect different degrees of severity of the
atherosclerotic process. Carotid artery stenosis is defined as
atherosclerotic narrowing of the proximal part of the internal carotid
artery, 70% in severe cases and 50% in moderately severe cases. The
presence of lacunar infarcts of the brain is associated with an
increased risk of dementia. Vascular risk factors and inflammatory
mechanisms are involved in the atherosclerotic process, so
determining the inflammatory activation can also be useful in the risk
assessment in patients with carotid artery disease. In our study, the
following results were obtained with respect to the correlation of risk
factors, carotid stenosis and cognitive disorder. The ...study is
prospective, by analyzing a total of 180 patients divided into 3
groups, aged 50-70 years: 1. Patients with stenotic changes of varying
degrees but without symptoms (no transient ischemic attack or brain
infarction). 2. A group of patients with symptomatic stenotic changes
(transient ischemic attack or brain infarction). 3. Control group of
patients with headache and vertiginous disorders with normal carotid
artery finding. The presence of hypertension, diabetes,
hypercholesterolaemia, and circulating levels of inflammatory
markers (Tumor necrotic factor alpha, C reactive protein, fibrinogen
and sedimentation leucocyte formula) was evaluated. Ultrasound
examination was used as a method to determine the carotid
arteriosclerosis. Cognitive functions will be assessed using the
Addenbrooke’s cognitive examination (ACE-R) test. Computed
tomography of the brain was performed on receipt and after a period
of 24-72 hours of admission, the size and location of the acute
ischemic lesion would be analyzed. Nuclear magnetic resonance of
the brain was made over a period of 6 months in all patients.
Asymptomatic carotid stenosis increases the risk of cognitive
impairment, and the severe degree of carotid stenosis right increases
the risk of severe cognitive impairment about 14 times, and severe
carotid stenosis left increases the risk of severe cognitive impairment
about 20 times.
