Percutaneous Transluminal Angioplasty as Potentially Effective Treatment for Persistent Cognitive Decline due to Intracranial Carotid Artery Stenosis

Objective: We describe a male patient with covert sustained cognitive impairment who underwent endovascular treatment for severe stenosis in the left intracranial internal carotid artery (ICA).Case Presentation: A 64-year-old man presented with transient dysarthria and dysphagia. Although he was ale...

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Bibliographic Details
Published in:Journal of Neuroendovascular Therapy 2020, Vol.14(1), pp.8-13
Main Authors: Sugimura, Yusuke, Nakajima, Makoto, Shindo, Seigo, Kuroki, Kenji, Namitome, Satoshi, Wada, Kuniyasu, Terasaki, Tadashi, Ando, Yukio
Format: Article
Language:jpn ; eng
Subjects:
Case Report
cognitive impairment
intracranial internal carotid artery stenosis
percutaneous transluminal angioplasty
revascularization therapy
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Summary:Objective: We describe a male patient with covert sustained cognitive impairment who underwent endovascular treatment for severe stenosis in the left intracranial internal carotid artery (ICA).Case Presentation: A 64-year-old man presented with transient dysarthria and dysphagia. Although he was alert, a cognitive evaluation revealed significant dysgraphia and a remarkable reduction in cognitive function. Diffusion-weighted imaging (DWI) revealed scattered high-intensity regions in the watershed area of the left cerebral hemisphere and severe stenosis in the C2 portion of the left ICA. Percutaneous transluminal angioplasty (PTA) was performed; a detailed examination revealed significantly improved cognitive function. One year later, the patient demonstrated further cognitive improvement, without any recurrent stroke.Conclusions: We consider that patients with severe intracranial stenosis, who have covert cognitive decline without apparent sustained symptoms, might be promising candidates for revascularization. Higher brain function in patients with severe intracranial arterial stenosis should be carefully screened because cognitive decline might not be evident at the time of initial presentation.
ISSN:1882-4072
2186-2494
DOI:10.5797/jnet.cr.2019-0071