Zhonghua nei ke za zhi · 2012
[Radiological imaging in evaluation of etiologies for cerebral infarction after non-cardiac surgeries].
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Song Hong-song, Fan Dong-sheng
Аннотация
OBJECTIVE: To investigate the pathogenesis of cerebral infarction after non-cardiac surgeries according to imaging.
METHODS: Retrospective analyses of clinical and imaging data of 17 patients with postoperative cerebral infarction (average 68 years old, total incidence 0.049%) from departments of orthopedics and general surgery were conducted during 52 months.
RESULTS: Cerebral infarction occurred 39.1 hours after operation on average. Among the 17 patients, eight were detected with disturbance of consciousness, ten with hemiplegia, six with speech disorder and two with unilateral sensory disturbance. Six (35.3%) had blood lipids tests. Five (29.4%) had neck vascular ultrasound and one had intracranial magnetic resonance angiography (MRA). When discharged, one patient was declared death and ten had impaired neurological function in various degrees. Among six patients with previous stroke, one (16.7%) received neurological consultation before surgery. According to the image manifestation, ten cases were territory circulation infarcts, four centrum ovale infarcts and three watershed infarcts.
CONCLUSIONS: This study suggests that total incidence of cerebral infarction after non-cardiac surgeries is lower than previously reported and there is greater involvement of atherosclerosis. Patients' conditions should be closely observed within at least four days after surgeries. Preoperative assessment should be strengthened in order to avoid occurrence of postoperative cerebral infarction.
METHODS: Retrospective analyses of clinical and imaging data of 17 patients with postoperative cerebral infarction (average 68 years old, total incidence 0.049%) from departments of orthopedics and general surgery were conducted during 52 months.
RESULTS: Cerebral infarction occurred 39.1 hours after operation on average. Among the 17 patients, eight were detected with disturbance of consciousness, ten with hemiplegia, six with speech disorder and two with unilateral sensory disturbance. Six (35.3%) had blood lipids tests. Five (29.4%) had neck vascular ultrasound and one had intracranial magnetic resonance angiography (MRA). When discharged, one patient was declared death and ten had impaired neurological function in various degrees. Among six patients with previous stroke, one (16.7%) received neurological consultation before surgery. According to the image manifestation, ten cases were territory circulation infarcts, four centrum ovale infarcts and three watershed infarcts.
CONCLUSIONS: This study suggests that total incidence of cerebral infarction after non-cardiac surgeries is lower than previously reported and there is greater involvement of atherosclerosis. Patients' conditions should be closely observed within at least four days after surgeries. Preoperative assessment should be strengthened in order to avoid occurrence of postoperative cerebral infarction.