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Cerebral microemboli during hip fracture fixation: a prospective study
Michal Barak1, Majed Kabha, Doron Norman
1Department of Anesthesiology, Rambam Health Care Campus and B. Rappaport Faculty of Medicine, Technion-Israel Institute of Technology, Haifa, Israel.
Anesthesia and Analgesia
|July 19, 2008
Summary
Cerebral microemboli, solid or gas, frequently occur during hip fracture surgery. This finding suggests a higher incidence of brain microembolism during orthopedic procedures than previously recognized.
Area of Science:
- Orthopedic Surgery
- Neurosurgery
- Vascular Surgery
Background:
- Cerebral fat microembolism is documented during hip and knee replacement surgeries.
- The occurrence of cerebral microembolism during hip fracture fixation remains understudied.
Purpose of the Study:
- To investigate the incidence of cerebral microembolism (solid or gas) during hip fracture fixation.
- To determine if cerebral microembolism is specific to hip or knee replacement procedures.
Main Methods:
- Prospective study involving patients undergoing urgent hip fracture fixation.
- Transcranial Doppler monitoring of middle cerebral arteries to detect microemboli during surgery.
Main Results:
- Twenty-two patients were analyzed; 41% showed evidence of cerebral microemboli.
- Microemboli detected were a combination of solid and gas.
- One patient experienced a postoperative cerebrovascular accident.
Conclusions:
- Cerebral microemboli are common during urgent hip fracture fixation.
- This phenomenon extends beyond hip and knee replacement surgeries.
- Further research is needed to understand the clinical significance of these microemboli.