New brain lesions are detected by MRI in 25% to 50% of patients after coronary artery bypass graft and valve surgery, though the association with long-term dementia is not yet firmly established.
Does MRI evidence of perioperative silent brain injury after cardiac surgery associate with long-term cognitive impairment?
Silent brain injury is common after cardiac surgery (25-50% by MRI), and its potential link to long-term cognitive decline warrants further investigation.
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.
Sun et al. (Wed,) conducted a review in Silent brain injury after cardiac surgery. Cardiac surgery was evaluated on New brain lesions detected by MRI. New brain lesions are detected by MRI in 25% to 50% of patients after coronary artery bypass graft and valve surgery, though the association with long-term dementia is not yet firmly established.