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Neurologic outcomes of preoperative acute silent cerebral infarction in patients with cardiac surgery.

Sim HT, Kim SR, Beom MS, Chang JW, Kim NR, Jang MH, Ryu SW - Korean J Thorac Cardiovasc Surg (2014)

Bottom Line: In two patients, postoperative DWI confirmed that no significant changes had occurred in the lesions.Patients with preoperative ASCI showed excellent postoperative neurologic outcomes.Preoperative ASCI was not a risk factor for postoperative neurologic deterioration.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic and Cardiovascular Surgery, Saint Carollo General Hospital.

ABSTRACT

Background: Acute cerebral infarction is a major risk factor for postoperative neurologic complications in cardiac surgery. However, the outcomes associated with acute silent cerebral infarction (ASCI) have not been not well established. Few studies have reported the postoperative outcomes of these patients in light of preoperative Diffusion-weighted magnetic resonance imaging (DWI). We studied the postoperative neurologic outcomes of patients with preoperative ASCI detected by DWI.

Methods: We retrospectively studied 32 patients with preoperative ASCI detected by DWI. None of the patients had preoperative neurologic symptoms. The mean age at operation was 68.8±9.5 years. Five patients had previous histories of stroke. Four patients had been diagnosed with infective endocarditis. Single cerebral infarct lesions were detected in 16 patients, double lesions in 13, and multiple lesions (>5) in three. The median size of the infarct lesions was 4 mm (range, 2 to 25 mm). The operations of three of the 32 patients were delayed pending follow-up DWI studies.

Results: There were two in-hospital mortalities. Neurologic complications also occurred in two patients. One patient developed extensive cerebral infarction unrelated to preoperative infarct lesions. One patient showed sustained delirium over one week but recovered completely without any neurologic deficits. In two patients, postoperative DWI confirmed that no significant changes had occurred in the lesions.

Conclusion: Patients with preoperative ASCI showed excellent postoperative neurologic outcomes. Preoperative ASCI was not a risk factor for postoperative neurologic deterioration.

No MeSH data available.


Related in: MedlinePlus

(A) A preoperative DWI image showed acute infarctions in the left frontal cortex and corona radiata. (B) A postoperative DWI image showed mildly decreased signal intensity at the same infarct area. DWI, diffusion-weighted magnetic resonance imaging.
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f2-kjtcvs-47-510: (A) A preoperative DWI image showed acute infarctions in the left frontal cortex and corona radiata. (B) A postoperative DWI image showed mildly decreased signal intensity at the same infarct area. DWI, diffusion-weighted magnetic resonance imaging.

Mentions: Postoperative DWI was performed in two of the 32 patients with preoperative ASCI. One patient who had two infarct lesions in the left frontal cortex and corona radiata on preoperative DWI showed severe dizziness postoperatively. The other patient with multiple preoperative infarct lesions did not show any specific neurologic symptoms postoperatively. On the postoperative DWI, both had similar findings and no evidence of exacerbation (Fig. 2).


Neurologic outcomes of preoperative acute silent cerebral infarction in patients with cardiac surgery.

Sim HT, Kim SR, Beom MS, Chang JW, Kim NR, Jang MH, Ryu SW - Korean J Thorac Cardiovasc Surg (2014)

(A) A preoperative DWI image showed acute infarctions in the left frontal cortex and corona radiata. (B) A postoperative DWI image showed mildly decreased signal intensity at the same infarct area. DWI, diffusion-weighted magnetic resonance imaging.
© Copyright Policy
Related In: Results  -  Collection

License
Show All Figures
getmorefigures.php?uid=PMC4279829&req=5

f2-kjtcvs-47-510: (A) A preoperative DWI image showed acute infarctions in the left frontal cortex and corona radiata. (B) A postoperative DWI image showed mildly decreased signal intensity at the same infarct area. DWI, diffusion-weighted magnetic resonance imaging.
Mentions: Postoperative DWI was performed in two of the 32 patients with preoperative ASCI. One patient who had two infarct lesions in the left frontal cortex and corona radiata on preoperative DWI showed severe dizziness postoperatively. The other patient with multiple preoperative infarct lesions did not show any specific neurologic symptoms postoperatively. On the postoperative DWI, both had similar findings and no evidence of exacerbation (Fig. 2).

Bottom Line: In two patients, postoperative DWI confirmed that no significant changes had occurred in the lesions.Patients with preoperative ASCI showed excellent postoperative neurologic outcomes.Preoperative ASCI was not a risk factor for postoperative neurologic deterioration.

View Article: PubMed Central - PubMed

Affiliation: Department of Thoracic and Cardiovascular Surgery, Saint Carollo General Hospital.

ABSTRACT

Background: Acute cerebral infarction is a major risk factor for postoperative neurologic complications in cardiac surgery. However, the outcomes associated with acute silent cerebral infarction (ASCI) have not been not well established. Few studies have reported the postoperative outcomes of these patients in light of preoperative Diffusion-weighted magnetic resonance imaging (DWI). We studied the postoperative neurologic outcomes of patients with preoperative ASCI detected by DWI.

Methods: We retrospectively studied 32 patients with preoperative ASCI detected by DWI. None of the patients had preoperative neurologic symptoms. The mean age at operation was 68.8±9.5 years. Five patients had previous histories of stroke. Four patients had been diagnosed with infective endocarditis. Single cerebral infarct lesions were detected in 16 patients, double lesions in 13, and multiple lesions (>5) in three. The median size of the infarct lesions was 4 mm (range, 2 to 25 mm). The operations of three of the 32 patients were delayed pending follow-up DWI studies.

Results: There were two in-hospital mortalities. Neurologic complications also occurred in two patients. One patient developed extensive cerebral infarction unrelated to preoperative infarct lesions. One patient showed sustained delirium over one week but recovered completely without any neurologic deficits. In two patients, postoperative DWI confirmed that no significant changes had occurred in the lesions.

Conclusion: Patients with preoperative ASCI showed excellent postoperative neurologic outcomes. Preoperative ASCI was not a risk factor for postoperative neurologic deterioration.

No MeSH data available.


Related in: MedlinePlus