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Brain Magnetic Resonance Imaging in Coronary Artery Bypass Grafts:A Pre-and Postoperative Assessment
Neurol 43:775-778, Schmidt,R.,et al, 1993
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Article Abstract
We undertook a study to determine(1)the frequency and prognostic significance of preexisting MRI brain abnormalities in patients undergoing coronary artery bypass grafts(CABG)and(2)whether MRI can detect surgery- related brain damage in 31 neurologically asymptomatic CABG patients(mean age 61.0+/-6.6 years).MRIs were performed within 7 days before and 8 to 19 days after surgery.When we compared the preoperative images with those of 31 age-and risk factor-matched neurologically asymptomatic controls free of cardiac disease(mean age 60.3+/-6.1 years),higher rates of thromboembolic infarcts(16%versus 0%),lacunes(58.1%versus 32.3%),and brainstem lesions(22.6%versus 3.8%)were noted.Subjective rating demonstrated significantly larger ventricles in patients than in controls (p=0.002).CABG candidates also had significantly increased ventricular-to- intracranial cavity ratios(VICR)as determined by semiquantitative volumetric measurements(6.9+/-2.5%versus 4.9+/-1.6%;p=0.004).Eleven patients had postsurgical complications,with eight having symptoms consistent with diffuse encephalopathy.The only MRI finding that separated encephalopathic from complication-free patients was ventricular size(VICR 9.0+/-2.5%versus 4.9+/-1.6%;p=0.006).This difference remained statistically significant after adjustment for the effects of age(p=0.04). Postoperative MRI consistently failed to demonstrate surgery-related brain damage responsible for the encephalopathy.
 
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cerebrovascular accident
coronary artery bypass
encephalopathy
microemboli
MRI
MRI,abnormal

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