0

The full content of Annals is available to subscribers

Subscribe/Learn More  >
Editorials |

Carotid Disease and Cognitive Dysfunction

H.J.M. Barnett, CC, MD
[+] Article and Author Information

From King City, Ontario L7B 1K4, Canada.


Potential Conflicts of Interest: None disclosed.

Requests for Single Reprints: H.J.M. Barnett, CC, MD, 14865, 7th Concession, King City, Ontario L7B 1K4, Canada; e-mail, hjmb@sympatico.ca.


Ann Intern Med. 2004;140(4):303-304. doi:10.7326/0003-4819-140-4-200402170-00013
Text Size: A A A

The introduction of cerebral angiography in the 1930s by Moniz, followed by detailed postmortem studies of the cervical portion of the carotid artery in the 1950s by Miller Fisher, drew attention to the extracranial carotid artery's being more important than the middle cerebral artery in ischemic stroke (1). The description of the diagnostic features of carotid disease soon followed, and this led to strategies for preventing or eliminating carotid lesions. From the earliest writings, clinical investigators have debated a possible connection between severe carotid disease and impaired cognition. Few dispute the relationship between cognitive decline and large areas of infarction of cortex supplied by the carotid artery. The unsettled component is the causal relationship between mild cognitive decline and asymptomatic disease in the carotid artery that supplies the dominant hemisphere (the left carotid in 98% of right-handed individuals). In the presence of intellectual changes, should an otherwise-asymptomatic person be called a symptomatic patient? Management could depend on the answer, and we will return to that subject at the end of this editorial.

First Page Preview

View Large
First page PDF preview

Figures

Tables

References

Letters

NOTE:
Citing articles are presented as examples only. In non-demo SCM6 implementation, integration with CrossRef’s "Cited By" API will populate this tab (http://www.crossref.org/citedby.html).

Comments

Submit a Comment
Submit a Comment

Summary for Patients

Clinical Slide Sets

Terms of Use

The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.

Toolkit

Buy Now

to gain full access to the content and tools.

Want to Subscribe?

Learn more about subscription options

Advertisement
Related Articles
Topic Collections
PubMed Articles
Forgot your password?
Enter your username and email address. We'll send you a reminder to the email address on record.
(Required)
(Required)