Document Detail

Stroke associated with coronary artery bypass surgery.
MedLine Citation:
PMID:  1950901     Owner:  NLM     Status:  MEDLINE    
Medical records and neuroimaging studies of 30 patients with major neurologic events after coronary artery surgery were reviewed. Two thousand and twenty-nine coronary artery bypass graft operations were performed in our institution between October 15, 1985, and December 27, 1989. Of these, there were 30 documented neurologic events suggesting acute ischemic injury during the intraoperative or the postoperative period. Clinical manifestations included hemiparesis, monoparesis, aphasia, bilateral cortical dysfunction, cortical and brainstem dysfunction, and left homonymous hemianopsia. There were five deaths directly attributable to neurologic injury. Twenty-two patients had a CT scan of the head, of which 15 showed evidence of acute infarction, two suggested watershed lesions from cerebral hypoperfusion, and the remainder showed findings consistent with multiple cerebral emboli or primary intracranial occlusion. Five carotid arteriograms and one digital subtraction arteriogram of the carotids were obtained. Angiographic findings revealed two common carotid artery occlusions, one callosal marginal artery occlusion, and two cases of bilateral high-grade internal carotid stenoses. Our findings support the contention that in patients who suffer cerebral infarction associated with coronary artery bypass grafting, the main mechanism of injury is cerebral embolization rather than cerebral hypoperfusion.
J H Hise; M L Nipper; J C Schnitker
Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  AJNR. American journal of neuroradiology     Volume:  12     ISSN:  0195-6108     ISO Abbreviation:  AJNR Am J Neuroradiol     Publication Date:    1991 Sep-Oct
Date Detail:
Created Date:  1991-12-17     Completed Date:  1991-12-17     Revised Date:  2008-02-14    
Medline Journal Info:
Nlm Unique ID:  8003708     Medline TA:  AJNR Am J Neuroradiol     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  811-4     Citation Subset:  IM    
Department of Radiology, Scott and White Clinic, Texas A & M University College of Medicine, Temple 76508.
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MeSH Terms
Brain / radiography
Cerebral Angiography
Cerebral Infarction / etiology,  mortality,  radiography
Cerebrovascular Disorders / etiology*
Coronary Artery Bypass / adverse effects*
Middle Aged
Tomography, X-Ray Computed
Comment In:
AJNR Am J Neuroradiol. 1991 Sep-Oct;12(5):815-6   [PMID:  1950902 ]
AJNR Am J Neuroradiol. 1991 Sep-Oct;12(5):817-8   [PMID:  1950903 ]

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