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Stroke associated with coronary artery bypass surgery.
J H Hise1, M L Nipper, J C Schnitker
1Department of Radiology, Scott and White Clinic, Texas A & M University College of Medicine, Temple 76508.
AJNR. American Journal of Neuroradiology
|September 1, 1991
Summary
Cerebral infarction after coronary artery bypass grafting is often caused by embolization, not hypoperfusion. This study reviews 30 neurologic events in patients undergoing bypass surgery.
Area of Science:
- Neurology
- Cardiovascular Surgery
Background:
- Neurologic events can occur after coronary artery bypass grafting (CABG).
- Acute ischemic injury is a concern during and after CABG procedures.
Purpose of the Study:
- To investigate the mechanisms of neurologic injury in patients undergoing CABG.
- To differentiate between cerebral embolization and hypoperfusion as causes of stroke post-CABG.
Main Methods:
- Retrospective review of medical records and neuroimaging for 30 patients with neurologic events post-CABG.
- Analysis of CT scans and carotid arteriograms to identify patterns of cerebral injury and vascular abnormalities.
Main Results:
- Thirty neurologic events were documented among 2029 CABG operations.
- CT scans revealed acute infarction in 15 patients, watershed lesions in two, and emboli/occlusion in others.
- Arteriography showed carotid artery occlusions and high-grade stenoses.
Conclusions:
- Cerebral embolization is the primary mechanism of ischemic injury in patients experiencing stroke after CABG.
- Findings challenge the notion that cerebral hypoperfusion is the main cause of infarction in this patient population.