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July 1981

Carotid Endarterectomy and the Mind-Reply

Author Affiliations

Vanderbilt University Nashville, TN 37232

Arch Neurol. 1981;38(7):469-470. doi:10.1001/archneur.1981.00510070103029

In Reply.—  We believe several aspects of our article merit more extended comment.First, for patients in our study, carotid endarterectomy was not undertaken as an experimental procedure to improve mentation. The surgery was performed in patients with a history of transient ischemic attacks, in an attempt to prevent further cerebrovascular episodes. We evaluated behavioral changes, but surgery was not performed with the purpose of effecting such changes.Second, in examining mean preoperative scores we did not find significant neuropsychological deficits in our patients who had carotid endarterectomy as compared with controls. This does not mean that patients with carotid disease and transient ischemic attacks are not at risk for such deficits. In fact, the improvement on some neuropsychological tests shown by patients after carotid endarterectomy implies that some functions were impaired preoperatively in some of them. The absence of cognitive impairment, as reflected in preoperative mean scores, may be attributed to

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