Skip to main content
Log in

Early neurological abnormalities following coronary artery bypass surgery

A Prospective Study

  • Published:
European archives of psychiatry and neurological sciences Aims and scope Submit manuscript

Summary

A prospective analysis of 78 patients undergoing coronary artery bypass surgery (CABS) was carried out to assess clinically the frequency and course of cerebral complications during the 1st postoperative week. Detailed evaluation of the patients showed that neurological abnormalities after CABS were common, occurring in 40 of the 78 patients (51%). However, there were no serious cerebral complications. Changes in reflexes and new focal signs were found in 26 and 25 cases respectively; in 7 patients (9%) they were confined to the first postoperative days. There was no statistically significant correlation between postoperative outcome and age, preoperative neurological state or bypass time. However, some strong associations could be calculated between a history of cerebrovascular signs or symptoms and the appearance of persisting focal signs or development reflexes during the 1st week after CABS.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Similar content being viewed by others

References

  • Aberg T (1988) Cerebral injury during open heart surgery: studies using functional, biochemical, and morphological methods. In: Hilberman M (ed) Brain injury and protection during heart surgery. Martinus Nijhoff, Boston, pp 1–12

    Google Scholar 

  • Bashein G, Bledsoe SW, Townes BD, Coppel DB (1988) Tools for assessing central nervous system injury in the cardiac surgery patient. In: Hilberman M (ed) Brain injury and protection during heart surgery. Martinus Nijhoff, Boston, pp 109–135

    Google Scholar 

  • Branthwaite MA (1972) Neurological damage related to openheart surgery. A clinical survey. Thorax 27:748–753

    Google Scholar 

  • Branthwaite MA (1973) Detection of neurological damage during open-heart surgery. Thorax 28:464–472

    Google Scholar 

  • Breuer AC, Furlan AJ, Hanson MR, Lederman RJ, Loop FD, Cosgrove DM, Greenstreet RL, Estafanous FG (1983) Central nervous system complications of coronary artery bypass graft surgery: prospective analysis of 421 patients. Stroke 14:682–687

    Google Scholar 

  • Caplan LR (1980) “Top of the basilar” syndrome. Neurology 30:72–79

    Google Scholar 

  • Carella F, Travaini G, Contri P, Guzzetti S, Botta M, Pieri E, Mangoni A (1988) Cerebral complications of coronary bypass surgery. A prospective study. Acta Neurol Scand 77:158–163

    Google Scholar 

  • Coffey CE, Massey EW, Roberts KB, Curtis S, Jones RH, Pryor DB (1983) Natural history of cerebral complications of coronary artery bypass graft surgery. Neurology 33:1416–1421

    Google Scholar 

  • De Reuck J, Sieben G, De Coster W, Van der Eecken H (1981) Stroke pattern and topography of cerebral infarcts. Eur Neurol 20:411–415

    Google Scholar 

  • Fisher CM (1982) Lacunar strokes and infarcts: a review. Neurology 32:871–876

    Google Scholar 

  • Götze P, Dahme B (1980) Psychopathological syndromes and neurological disturbances before and after open-heart surgery. In: Speidel H, Rodewald G (eds) Psychic and neurological dysfunctions after open-heart surgery. Thieme, Stuttgart, pp 48–67

    Google Scholar 

  • Javid H, Tufo HM, Najafi H, Dye WS, Hunter JA, Julian DC (1969) Neurological abnormalities following open-heart surgery. J Thorac Cardiovasc Surg 58:502–509

    Google Scholar 

  • Landau WM (1989) Reflex dementia: disinhibited primitive thinking. Neurology 39:133–137

    Google Scholar 

  • Lienert GA (1971) Die Konfigurationsfrequenzanalyse. I. Ein neuer Weg zu Typen und Syndromen. Z Klin Psych Psychother 19:99–115

    Google Scholar 

  • Maertens de Noordhout A, Delwaide PJ (1988) The palmomental reflex in Parkinson's disease. Comparisons with normal subjects and clinical relevance. Arch Neurol 45:425–427

    Google Scholar 

  • Malone M, Prior P, Scholtz CL (1981) Brain damage after cardiopulmonary by-pass: correlations between neurophysiological and neuropathological findings. J Neurol Neurosurg Psychiatry 44:924–931

    Google Scholar 

  • Meyendorf R (1976) Hirnembolie und Psychose. Unter besonderer Berücksichtigung der Basalganglienapoplexie bei Herzoperationen mit extrakorporaler Zirkulation. J Neurol 213:163–177

    Google Scholar 

  • Mohr JP (1979) Neurological complications of cardiac valvular disease and cardiac surgery including systemic hypotension. In: Vinken PJ, Bruyn GW (eds) Handbook of clinical neurology, vol 38. North-Holland, Amsterdam, pp 143–171

    Google Scholar 

  • Nathan PW, Smith MC (1955) The Babinski response: a review and new observations. J Neurol Neurosurg Psychiatry 18:250–259

    Google Scholar 

  • Sarnquist FH (1988) Neurological outcome after “low flow low pressure” cardiopulmonary bypass. In: Hilberman M (ed) Brain injury and protection during heart surgery. Martinus Nijhoff, Boston, pp 13–25

    Google Scholar 

  • Shaw PJ, Bates D, Cartlidge N, Heaviside D, Julian D, Shaw D (1985) Early neurological complications of coronary artery bypass surgery. Br Med J 291:1384–1387

    Google Scholar 

  • Smith PL, Treasure T, Newman SP, Joseph P, Ell PJ, Schneidau A, Harrison MJ (1986) Cerebral consequences of cardiopulmonary bypass. Lancet I:823–825

    Google Scholar 

  • Sotaniemi KA (1983) Cerebral outcome after extracorporeal circulation. Comparison between prospective and retrospective evaluations. Arch Neurol 40:75–77

    Google Scholar 

  • Sotaniemi KA, Mononen H, Hokkanen TE (1986) Long-term cerebral outcome after open-heart surgery. A five-year neuropsychological follow-up study. Stroke 17:410–416

    Google Scholar 

  • Stockard JJ, Bickford RG, Schauble JF (1973) Pressure-dependent cerebral ischemia during cardiopulmonary bypass. Neurology 23:521–529

    Google Scholar 

  • Toole JF (1984) Cerebrovascular disorders, 3rd edn. Raven Press, New York

    Google Scholar 

  • Tufo HM, Ostefield AM, Shekelle R (1970) Central nervous system dysfunction following open-heart surgery. JAMA 212:1333–1340

    Google Scholar 

  • Tweedy J, Reding M, Garcia C, Schulman P, Deutsch G, Antin S (1982) Significance of cortical disinhibition signs. Neurology 32:169–173

    Google Scholar 

  • Van Gijn J (1978) The Babinski sign and the pyramidal syndrome. J Neurol Neurosurg Psychiatry 41:865–873

    Google Scholar 

  • Von Eye A (1988) Some multivariate developments in non-parametric statistics. In: Nesselroade JR, Cattell RB (eds) Handbook of multivariate experimental psychology. Plenum Press, New York, pp 367–398

    Google Scholar 

Download references

Author information

Authors and Affiliations

Authors

Rights and permissions

Reprints and permissions

About this article

Cite this article

Strenge, H., Lindner, V., Paulsen, G. et al. Early neurological abnormalities following coronary artery bypass surgery. Eur Arch Psychiatr Neurol Sci 239, 277–281 (1990). https://doi.org/10.1007/BF01738584

Download citation

  • Received:

  • Issue Date:

  • DOI: https://doi.org/10.1007/BF01738584

Key words

Navigation