Analysis of the level of a laboratory marker of cerebral ischemia with an assessment of neurocognitive status in the surgical treatment of pathological tortuosity of the ICA

Batrashov V.A., Borshchev G.G., Yudaev S.S., Zemlyanov A.V., Marynich A.A.

This article analyzes the laboratory marker of cerebral ischemia at various stages of treatment with the assessment of the neurocognitive status of patients by a specialized questionnaire at the pre- and postoperative stages, depending on the degree of cerebrovascular insufficiency.

As a result, it was revealed that the level of the NSE marker is statistically significantly lower with the use of a temporary shunt (17.5±3.4 mcg/l) than with operations without a shunt (20.1±2.7 mcg/l) (p<0.05). Temporary shutdown of blood flow through the carotid arteries during the operation of resection of the tortuosity of the ICA is accompanied by a mandatory significant increase in the concentration of the marker of brain damage, followed by the restoration of markers on the 3rd day after surgery (the level of NSE before surgery — 16.35 mcg/ l, after surgery — 12.40 mcg/l (p<0.05)). When assessing among all types of tortuosity, the highest value of NSE was found in patients with kinking (before surgery — 19.6 mcg/l, intraoperatively — 23.45±2.33 mcg/l, in the postoperative period — 14.70 mcg/l (p<0.05)).

When assessing the neurocognitive status of the questionnaire after resection of the pathological tortuosity of the ICA, an increase in the number of points was noted for all degrees of cerebrovascular insufficiency (I. before surgery-26 points, after surgery- 28; II. before surgery- 25 points, after surgery- 27 points; III. before surgery- 25 points, after surgery- 26 points; IV art. before surgery — 23 points, after surgery — 25 points (p <0.05)). As a result, it is concluded that a comprehensive assessment of cerebral ischemia at the intraoperative stage during resection of pathological tortuosity can be carried out using a laboratory marker of ischemia in routine practice in order to reliably assess ischemia at the level of brain neurons, and the performed operation for resection of pathological tortuosity of the ICA is accompanied by an improvement in cognitive functions up to 6 months after the operation according to the questionnaire.

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