Bibliographic Details
| Title: |
Cerebrovascular accidents after cardiac surgery: an analysis of CT scans in relation to clinical symptoms. |
| Authors: |
Hedberg, Magnus1 (AUTHOR), Boivie, Patrik1 (AUTHOR) patrik.boivie@vll.se, Edström, Cecilia1 (AUTHOR), Engström, Karl G.1 (AUTHOR) |
| Source: |
Scandinavian Cardiovascular Journal. Oct2005, Vol. 39 Issue 5, p299-305. 7p. 3 Charts, 1 Graph. |
| Subject Terms: |
*CARDIAC surgery, *CEREBROVASCULAR disease, *BRAIN diseases, *TOMOGRAPHY, *MANIPULATION therapy, *THERAPEUTIC embolization |
| Abstract: |
There is a link between aortic manipulation, particle embolization, and cerebrovascular accidents (CVA) in cardiac surgery. The present aim was to study hemispheric side differences of CVA. Cardiac-surgery patients with CVA and with computer tomography (CT) performed (n = 77) were analyzed within a total group of 2641 consecutive cases. CT data were reviewed for hemispheric and vascular distribution, and compared with CVA-symptom data of immediate and delayed type. Of the included patients, 66% had positive CT. In the group of 'cardiac-type' operations (e.g., routine clamping and cannulation) and having immediate CVA, right-hemispheric lesions were more frequent than of the contra-lateral side (p = 0.005). Patients with aortic dissections had strong dominance of bilateral findings, which was different from the unilateral pattern of 'cardiac-type' operations (p = 0.001). The middle-cerebral artery territory dominated, and when involved showed a significant (p = 0.022) right-sided distribution. Both CT and clinical symptoms confirmed that CVA after cardiac surgery has a right-hemispheric predominance. These observations may imply that aortic manipulation directs embolic material towards the brachiocephalic trunk. [ABSTRACT FROM AUTHOR] |
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