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Editorial |

Protecting the Brains of Patients After Heart Surgery

Louis R. Caplan, MD
Arch Neurol. 2001;58(4):549-550. doi:10.1001/archneur.58.4.549.
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MORE AND more heart surgeries are performed each year, and while these operations often improve heart function and may even prolong life, they can cause brain injury. Strokes, encephalopathies, and cognitive and behavioral abnormalities are well-known frequent complications of heart surgery. The frequency of neurologic abnormalities depends on how thoroughly patients are evaluated. More than a third of patients have persistent cognitive abnormalities shown by testing 1 year after surgery.1 Wityk and his Johns Hopkins colleagues2 now show that modern magnetic resonance imaging (MRI) technology documents multifocal brain lesions characteristic of embolism in 10 of 14 patients with neurologic complications of cardiac surgery. Their study2 provides another example of the great utility of diffusion and perfusion-weighted MRI in patients with cerebrovascular disease.

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Cholesterol crystals and other particulate debris caught in a filter placed in the aorta at the time that aortic clamps were removed (Reprinted with permission from Butterworth-Heinemann, Boston, Mass, publisher of Caplan's Stroke: A Clinical Approach, by Louis R. Caplan, figure 16.5, page 458).

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