Preoperative neurobehavioral impairment in cerebral revascularization candidates

We examined level of performance in 40 candidates for cerebral revascularization and found substantial variability on general indices of neuropsychological performance. Patients differed by duration of their longest ischemic attack, by surgery type, but not by time since onset of their first ischemic attack. Duration of the longest ischemic attack correlated highly with neuropsychological summary scores. In contrast, symptom duration was unrelated to level of performance in 18 additional patients with histories consistent with cerebrovascular ischemia who did not undergo surgery subsequently. We concluded that initial status on neuropsychological tests is an important variable to consider in postoperative followup of patients undergoing cerebral revascularization. More detailed clinical history and finer grained analysis of neuropsychological data promised to reveal additional relationships among clinical symptoms, neurobehavioral data, and underlying neuropathology.