Прогностическое значение симптомов дисциркуляторной энцефалопатии в кардиохирургии

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Abstract

Prognostic significance of some mild neurological disturbances that are frequently seen in cardiac surgery patients remains unclear. This study addressed prognostic value of preoperative neurological complains (vertigo, tinnitus, etc.) and neurological soft signs (primitive reflexes, slight unilateral hyperreflexia, etc.) towards neurological outcomes of on-pump surgery. Patients with symptoms of chronic disturbances of circulation in vertebro-basilar vasculature developed acute perioperative encephalopathia significantly more often in comparison to patients with normal neurological status. At the same time reflex alterations did not predict early neurological outcomes in cardiac surgery patients.

References

1. Дамулин, И. В. Нарушения кровообращения в головном и спинном мозге / И. В. Дамулин, В. А. Парфенов, А. А. Скоромец, Н. Н. Яхно // Болезни нервной системы: руководство для врачей; под ред. Н. Н. Яхно, Д. Р. Штульмана. - 2-е изд. - М.: Медицина, 2001. - С. 231-302.
2. Костылев, А. Н. Влияние сопутствующей верте- бробазилярной недостаточности на постнар- козное восстановление / А. Н. Костылев // Анестезиол. и реаниматол. - 2004. - № 3. - С. 17-20.
3. Andrell, P. White matter disease in magnetic resonance imaging predicts cerebral complications after coronary artery bypass grafting / P. Andrell, C. Jensen, H. Norrsell et al. // Ann. Thorac. Surg. - 2005. - Vol. 79, № 1. - P. 74-79.
4. Arrowsmith, J. E. Central nervous system complications of cardiac surgery / J. E. Arrowsmith, H. P. Grocott, J. G. Reves, M. F. Newman // Br. J. Anaesth. - 2000. - Vol. 84, № 3. - P. 378-393.
5. Blacker, D. J. Risk of ischemic stroke in patients with symptomatic vertebrobasilar stenosis undergoing surgical procedures / D. J. Blacker, K. D. Flemming, E. F. M. Wijdicks // Stroke. - 2003. - Vol. 34. - P. 2659-2663.
6. Bokeriia, L. A. Asymmetric cerebral embolic load and postoperative cognitive dysfunction in cardiac surgery / L. A. Bokeriia, E. Z. Golukhova, N. Y. Breskina et al. // Cerebrovascular. Diseases. - 2007. - Vol. 23. - P. 50-56.
7. Bokeriia, L. A. Neural correlates of cognitive dysfunction after cardiac surgery / L. A. Bokeriia, E. Z. Golukhova, A. G. Polunina et al. // Brain. Res. Brain. Res. Rev. - 2005. - Vol. 50/2. - P. 266-274.
8. Georgiadis, D. Predictive value of S-100beta and neuron-specific enolase serum levels for adverse neurologic outcome after cardiac surgery / D. Georgiadis, A. Berger, E. Kowatschev et al. // J. Thorac. Cardiovasc. Surg. - 2000. - Vol. 119, № 1. - P. 138-147.
9. Sotaniemi, K. A. Long-term cerebral outcome after open-heart surgery. A five-year neuropsychological follow-up study / K. A. Sotaniemi, H. Mononen, T. E. Hokkanen // Stroke. - 1986. - Vol. 17, № 3. - P. 410-416.
10. Weintraub, M. I. Cerebral hemodynamic changes induced by simulated tracheal intubation: a possible role in perioperative stroke? Magnetic resonance angiography and flow analysis in 160 cases / M. I. Weintraub, A. Khoury // Stroke. - 1998. - Vol. 29. - P. 1644-1649.

Chief Editor

Leo A. Bockeria, MD, PhD, DSc, Professor, Academician of Russian Academy of Sciences, President of Bakoulev National Medical Research Center for Cardiovascular Surgery