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Silent brain injury after cardiac surgery: a review: cognitive dysfunction and magnetic resonance imaging diffusion-weighted imaging findings. [Review]

MedStar author(s):

Citation: Journal of the American College of Cardiology. 60(9):791-7, 2012 Aug 28.PMID: 22917003Institution: MedStar Heart & Vascular Institute | MedStar Washington Hospital CenterDepartment: Medicine | RadiologyForm of publication: Journal ArticleMedline article type(s): Journal Article | ReviewSubject headings: *Brain Infarction/et [Etiology] | *Brain Injuries/et [Etiology] | *Cardiac Surgical Procedures/ae [Adverse Effects] | *Cognition Disorders/et [Etiology] | *Postoperative Complications/et [Etiology] | Brain Infarction/di [Diagnosis] | Brain Infarction/ep [Epidemiology] | Brain Injuries/di [Diagnosis] | Brain Injuries/ep [Epidemiology] | Cognition Disorders/di [Diagnosis] | Cognition Disorders/ep [Epidemiology] | Cognition/ph [Physiology] | Dementia/et [Etiology] | Diffusion Magnetic Resonance Imaging | Humans | Incidence | Postoperative Complications/di [Diagnosis] | Postoperative Complications/ep [Epidemiology]Year: 2012 Local holdings: Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007ISSN:

0735-1097

Name of journal: Journal of the American College of CardiologyAbstract: The appearance of cognitive dysfunction after cardiac surgery in the absence of focal neurologic signs, a poorly understood but potentially devastating complication, almost certainly results from procedure-related brain injury. Confirmation of the occurrence of perioperative silent brain injury has been developed through advances in magnetic resonance imaging (MRI) techniques. These techniques detect new brain lesions in 25% to 50% of patients after both coronary artery bypass graft and valve surgery. Use of post-operative cognitive dysfunction as a marker of brain injury is problematic because of potential difficulties in ascertainment. It can be hypothesized that post-operative appearance of MRI lesions may serve as a more objective marker of brain injury in research efforts. If MRI examination can be used in this way, then 2 vitally important questions can be addressed. 1) What is the frequency of important, but silent, brain injury during cardiac surgery? 2) Does long-term cognitive impairment ensue? This review briefly discusses clinical features of post-operative cognitive dysfunction and reviews the evidence supporting a possible association with MRI evidence of perioperative brain injury and its potential for long-term dementia. We conclude that this association is plausible, but not yet firmly established. Copyright 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.All authors: Corso PJ, Hill PC, Lindsay J, Monsein LH, Sun XFiscal year: FY2013Digital Object Identifier:

http://dx.doi.org/10.1016/j.jacc.2012.02.079

Date added to catalog: 2013-09-17

Holdings ( 1 )
Title notes ( 3 )

Holdings
Item type	Current library	Collection	Call number	Status	Date due	Barcode
Journal Article	MedStar Authors Catalog	Article	22917003	Available		22917003

Available online from MWHC library: 1995 - present, Available in print through MWHC library:1999-2007

The appearance of cognitive dysfunction after cardiac surgery in the absence of focal neurologic signs, a poorly understood but potentially devastating complication, almost certainly results from procedure-related brain injury. Confirmation of the occurrence of perioperative silent brain injury has been developed through advances in magnetic resonance imaging (MRI) techniques. These techniques detect new brain lesions in 25% to 50% of patients after both coronary artery bypass graft and valve surgery. Use of post-operative cognitive dysfunction as a marker of brain injury is problematic because of potential difficulties in ascertainment. It can be hypothesized that post-operative appearance of MRI lesions may serve as a more objective marker of brain injury in research efforts. If MRI examination can be used in this way, then 2 vitally important questions can be addressed. 1) What is the frequency of important, but silent, brain injury during cardiac surgery? 2) Does long-term cognitive impairment ensue? This review briefly discusses clinical features of post-operative cognitive dysfunction and reviews the evidence supporting a possible association with MRI evidence of perioperative brain injury and its potential for long-term dementia. We conclude that this association is plausible, but not yet firmly established. Copyright 2012 American College of Cardiology Foundation. Published by Elsevier Inc. All rights reserved.

English