TITLE

Evaluation of brain injury after coronary artery bypass grafting. A prospective study using neuropsychological assessment and diffusion-weighted magnetic resonance imaging

AUTHOR(S)
Knipp, Stephan C.; Matatko, Nadine; Wilhelm, Hans; Schlamann, Marc; Massoudy, Parwis; Forsting, Michael; Diener, Hans Christian; Jakob, Heinz
PUB. DATE
May 2004
SOURCE
European Journal of Cardio-Thoracic Surgery;May2004, Vol. 25 Issue 5, p791
SOURCE TYPE
Academic Journal
DOC. TYPE
Article
ABSTRACT
Objective: Neurocognitive dysfunction is a common complication after cardiac surgery with cardiopulmonary bypass (CPB). Studies using magnetic resonance imaging (MRI) have demonstrated that new focal brain lesions can occur after coronary artery bypass grafting (CABG), even in patients without apparent neurological deficits. Diffusion-weighted MRI is superior to conventional MRI and allows for sensitive and early detection of ischemic brain lesions. We prospectively investigated cerebral injury early and 3 months after CABG using diffusion-weighted MRI and related the findings to clinical data and neurocognitive functions. Methods: Twenty-nine patients [67.6±8.6 (52–85) years, 5 females] undergoing elective CABG with CPB were examined before surgery, at discharge and 3 months after surgery. A battery of standardized neuropsychological tests and questionnaires on depression and mood were administered. Conventional and diffusion-weighted MRI of the brain was performed and new lesions were analyzed. Clinical characteristics, neuropsychological test performance and radiographic data were collected and compared. Results: There was no major neurological complication after CABG. Thirteen patients (45%) exhibited 32 new ischemic lesions on postoperative diffusion-weighted MRI. The lesions were small, rounded and equally dispersed in both hemispheres. Eight patients had at least two lesions. At discharge, significant deterioration of neuropsychological performance was observed in 6 of the 13 tests compared to baseline assessment. By 3 months postoperatively, 5 of the 6 tests returned to preoperative levels. Verbal learning ability, however, remained impaired. The presence of new focal brain lesions was not associated with impaired neuropsychological performance. There was also no correlation between clinical variables, intraoperative parameters and postoperative complications and MRI findings. Conclusions: Although neurocognitive decline after CABG is mostly transient, memory impairment can persist for months. New ischemic brain lesions on postoperative diffusion-weighted MRI do not appear to account for the persistent neurocognitive decline.
ACCESSION #
12779353

 

Related Articles

  • Myocardial infarction after blunt chest trauma: usefulness of cardiac ECG-gated CT and MRI for positive and aetiologic diagnosis. Malbranque, Gregory; Serfaty, Jean Michel; Himbert, Dominique; Steg, Philippe Gabriel; Laissy, Jean Pierre // Emergency Radiology;May2011, Vol. 18 Issue 3, p271 

    Myocardial infarction after blunt chest trauma has been reported in only few cases, and mechanisms of this complication have rarely been described. We report two cases of coronary artery lesions, one parietal hematoma of right coronary artery and one dissection of the left main coronary artery,...

  • Neuropsychological and MRI measures predict short-term evolution in benign multiple sclerosis.  // Current Medical Literature: Multiple Sclerosis;2009, Vol. 1 Issue 3, p73 

    The article reports on the result of the study aimed to assess whether the use of neuropsychological tests and magnetic resonance imaging (MRI) measures can predict short-term disease evolution in patients with benign multiple sclerosis (MS). It includes 63 MS patients asked to undergo...

  • T1 cortical hypointensities and their association with cognitive disability in multiple sclerosis. Bagnato, Francesca; Salman, Zeena; Kane, Robert; Sungyoung Auh; Cantor, Fredric K.; Ehrmantraut, Mary; Gallo, Antonio; Ikonomidou, Vasiliki N.; Ohayon, Joan; Pellicano, Clelia; Stern, Susan K.; McFarland, Henry F. // Multiple Sclerosis (13524585);Oct2010, Vol. 16 Issue 10, p1203 

    Background: Neocortical lesions (NLs) largely contribute to the pathology of multiple sclerosis (MS), although their relevance in patients' disability remains unknown. Objective: To assess the incidence of T1 hypointense NLs by 3.0-Tesla magnetic resonance imaging (MRI) in patients with MS and...

  • Acute severe memory impairment as a presenting symptom of multiple sclerosis: a clinical case study with 3D double inversion recovery MR imaging. Coebergh, J. A. F.; Roosendaal, S. D.; Polman, C. H.; Geurts, J. J.; van Woerkom, T. C. A. M. // Multiple Sclerosis (13524585);12/01/2010, Vol. 16 Issue 12, p1521 

    We present the case of a 21-year-old woman with acute memory impairment. It was initially not recognized as organic in nature. Repeated neuropsychological testing confirmed severely disturbed encoding and recall. Three-dimensional double inversion recovery (3D-DIR) MRI confirmed hippocampal and...

  • INTRODUCTION. Cummings, Jeffrey L. // CNS Spectrums: The International Journal of Neuropsychiatric Med;Oct2008 Supplement 16, Vol. 13 Issue 10, p4 

    The article cites new tools, techniques and strategies in treating patients with Alzheimer's disease. The Mini-Cog and Montreal Cognitive Assessment have emerged to help primary care practitioners in identifying potential problems of patients. The Neuropsychological Test Battery allows both...

  • Evaluating functional MRI procedures for assessing hemispheric language dominance in neurosurgical patients. Baciu, M. V.; Watson, J. M.; Maccotta, L.; McDermott, K. B.; Buckner, R. L.; Gilliam, F. G.; Ojemann, J. G. // Neuroradiology;Nov2005, Vol. 47 Issue 11, p835 

    Two methods of quantifying hemispheric language dominance (HLD) in neurosurgical patients are compared: (1) an average magnitudes (AM) method, which is a calculation of the average signal intensity variation in regions of interest for each patient that were predefined in a group analysis for...

  • Distributed changes in default-mode resting-state connectivity in multiple sclerosis. Bonavita, Simona; Gallo, Antonio; Sacco, Rosaria; Della Corte, Marida; Bisecco, Alvino; Docimo, Renato; Lavorgna, Luigi; Corbo, Daniele; Di Costanzo, Alfonso; Tortora, Fabio; Cirillo, Mario; Esposito, Fabrizio; Tedeschi, Gioacchino // Multiple Sclerosis Journal;04/01/2011, Vol. 17 Issue 4, p411 

    Background: The default-mode network (DMN) has been increasingly recognized as relevant to cognitive status.Objectives: To explore DMN changes in patients with relapsing—remitting (RR) multiple sclerosis (MS) and to relate these to the cognitive status.Methods: Eighteen cognitively...

  • Diffusion-weighted imaging predicts cognitive impairment in multiple sclerosis. Benedict, Ralph H. B.; Bruce, Jared; Dwyer, Michael G.; Weinstock-Guttman, Bianca; Tjoa, Chris; Tavazzi, Eleonora; Munschauer, Frederick E.; Zivadinov, Robert // Multiple Sclerosis (13524585);Jul2007, Vol. 13 Issue 6, p722 

    Following a previous study with diffusion tensor imaging, we investigated the correlation between diffusion-weighted imaging (DWI) and cognitive dysfunction in multiple sclerosis (MS). We studied 60 MS patients (mean age 45.8±/9.0 years) using 1.5-T MRI. Disease course was RR = /40 and SP =...

  • Single and Combined Effects of Cerebral White Matter Lesions and Lacunar Infarctions on Cognitive Function in an Elderly Population. Baune, Bernard T.; Roesler, Andreas; Knecht, Stefan; Berger, Klaus // Journals of Gerontology Series A: Biological Sciences & Medical ;Jan2009, Vol. 64A Issue 1, p118 

    Background. This study is to investigate the association between single and combined vascular brain changes (white matter lesions [WMLs], lacunar infarctions) and the cognitive domains of memory, processing speed, and motor function in the elderly adults. Methods. In a sample of 268 participants...

Share

Read the Article

Courtesy of VIRGINIA BEACH PUBLIC LIBRARY AND SYSTEM

Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics