Last update:

   29-Sep-2023
 

Arch Hellen Med, 40(5), September-October 2023, 668-675

HISTORY OF MEDICINE

Historical context of the impact of carotid artery disease
and revascularization techniques on patient's cognitive and mental function

C.C. Liapis,1,2,3 C.D. Liapis1,4
1National and Kapodistrian University of Athens, Athens,
2Therapy Center for Dependent Individuals, Athens,
3Committee of Public Health Experts, Athens,
4Clinic of Vascular and Endovascular Surgery, Athens Medical Center, Athens, Greece

Carotid stenosis is a common vascular occlusive disease related to increased risk of stroke and considered to have a severe impact on cognition, due to cerebral blood flow disorders, as well as due to the hemodynamic mechanisms of microemboli and hypoperfusion. Depictions of this pathophysiological correlation with apoplectic symptoms and other neurological manifestations can be traced back to the Homeric Epics and later to the Hippocratic Corpus. In modern times, the effectiveness of carotid artery revascularization technics in preventing ischemic cerebrovascular disease has been studied since 1959. Modern, multidisciplinary examination of changes in cognitive function following CEA or CAS in relation to cerebral blood flow (CBF) reflects the historical perspective and evolution of the empirical recognition and belletristic, ancient descriptions of the core significance that cervical vessels pose in preserving mental functioning, as well as human life per se. The long historic and scientific road that has been traversed from war duels and killing scenes in the Iliad and the Odyssey, where warlords and kings used to aim at their opponents cervical and jugular region, to Ambroise Pare's first carotid ligation and to Jose Saramago's narrations about King John's III carotid blood flow and cerebral oxygen supply alternations, verifies that clinical observation and diagnostic methodology might have a lot to gain through contact with the fields of classical studies, literature and history as well.

Key words: Carotid artery disease, Carotid artery stenting, Carotid endarterectomy, Cognitive function, Depression, Historical context.


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