Morphological damage to the central nervous system (CNS) following open heart surgery

Herczeg, László; Gorombey, Steve; Vaszily, Miklós

doi:10.1016/0379-0738(96)01896-8

Cited by 8 publications

(7 citation statements)

References 23 publications

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“…On the other hand, our incidence of cerebral hemorrhage was low, only 0.7% compared with the 2.8% found by Lee et al [16] with 108 autopsy patients. Our low incidence of cerebral edema, 51%, compared to the 100% of Herczeg et al [15] is probably due to the definition of cerebral edema, as in the study of Herczeg et al the milder forms of edema were also included.…”

Section: Discussionmentioning

confidence: 82%

“…All nine infarcts were border zone in character. The incidence of anoxic brain damage defined as punctate cortical hemorrhage was 7.5% according to Herczeg et al [15], but somewhat lower in this study at 4.9%. On the other hand, our incidence of cerebral hemorrhage was low, only 0.7% compared with the 2.8% found by Lee et al [16] with 108 autopsy patients.…”

Section: Discussionmentioning

confidence: 86%

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Cerebral cast angiography as an aid to medicolegal autopsies in cases of death after adult cardiac surgery

Saimanen

Järvinen

Penttilä

2001

International Journal of Legal Medicine

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Due to an increase in age of the patient population in cardiac surgery, cerebral complications are increasing in frequency, also as a cause of death. In order to reveal cerebral pathology associated with a fatal outcome after cardiac surgery, we re-evaluated the cast angiographs and medico-legal autopsy documents of 144 adult cardiac surgery subjects over a 7-year period. Special attention was paid to the ability of post-mortem cast angiography to aid in diagnosing cerebral pathology. The autopsy detected new ischemic cerebral lesions in 29 (20%) cases, of which 22 (15.3%) were recent infarcts, and 7 were cases of anoxic brain damage. Of the recent cerebral infarcts, 12 were associated with cerebral artery thrombosis, 4 showed multiple lesions, and the remaining 6 were small single infarcts. In addition, one subject had an intracerebral hemorrhage and 72 (50%) cerebral edema. By cast angiography, the leakage of contrast medium in the case of intracerebral hemorrhage and stenoses of intracranial and cervical arteries could be well demonstrated and also revealed 17 (77%) of the 22 recent cerebral infarcts. It was found to be suitable for detecting recent brain infarcts associated with main cerebral artery thrombosis, with a sensitivity of 92% (11 out of 12 cases), but was less sensitive in showing small recent infarcts with a sensitivity of 60% (6 out of 10 cases) and inferior for the older ones where none of the 6 cases were detected. Filling defects caused by cerebral edema were difficult to differentiate from technical errors and were encountered in 7 (4.8%) cases. A significant predictor for the 29 recent ischemic brain lesions was perioperative hypotension. The immediate cause of death was most often of cardiac (83%) and cerebral (14%) origin. In 14 cases, cerebral damage was considered to be an additional cause of death. The use of cerebral post-mortem cast angiography should be recommended, especially for its excellent ability to visualize intravascular pathology such as arterial stenoses and thromboses, with a 92% sensitivity in showing new main cerebral artery thromboses, before likely distortion of the vascular anatomy by dissection.

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Section: Discussionmentioning

confidence: 82%

Section: Discussionmentioning

confidence: 86%

Cerebral cast angiography as an aid to medicolegal autopsies in cases of death after adult cardiac surgery

Saimanen

Järvinen

Penttilä

2001

International Journal of Legal Medicine

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“…Ungünstig wirkt sich jedoch aus, daû diese Substanzen keine analgetischen Eigenschaften besitzen. Jüngsten Untersuchungen zufolge sollen sie sogar den analgetischen Eigenschaften von Opioiden entgegenwirken [8]. Der Einsatz von GABA A -Rezeptor-Agonisten könnte eine interessante Alternative sein, denn diese Substanzen wirken anxiolytisch, analgetisch und sedierend zugleich [10].…”

Section: Ergebnisseunclassified

“…Die Kanäle TREK und TRAAK sind auch mechanosensitiv [7,9]. Ein TASK-ähnlicher Kanal scheint in Zellen der Neuroepithelkörperchen des Bronchialsystems für deren O 2 -Sensitivität verantwortlich zu sein [8]. [2]; z.…”

Section: Ergebnisseunclassified

“…So wird unter anderem über reduziertes Schmerzempfinden nach Ethanolaufnahme berichtet [11]. Vor kurzem wurde die Existenz und Funktion des BK Ca Kanals in kleinen sensorischen Neuronen der Hinterwurzelganglien (DRG) beschrieben [8]. Dabei konnte gezeigt werden, dass die BK Ca Kanäle sowohl einzelne Aktionspotentiale (AP) als auch die Refraktärzeit nach einem Aktionspotential beeinflussen und dadurch die Feuerrate dieser Neurone reduzieren können.…”

Section: Ergebnisseunclassified

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Unincorporated Channel Meeting (UCM) - Grundlagenforschung über Mechanismen der Anästhesie

Tonner¹,

Urban²

2004

Anästhesiol Intensivmed Notfallmed Schmerzther

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Iatrogenic Injury

Lau

Forensic Pathology Reviews

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Morphological damage to the central nervous system (CNS) following open heart surgery

Cited by 8 publications

References 23 publications

Cerebral cast angiography as an aid to medicolegal autopsies in cases of death after adult cardiac surgery

Cerebral cast angiography as an aid to medicolegal autopsies in cases of death after adult cardiac surgery

Unincorporated Channel Meeting (UCM) - Grundlagenforschung über Mechanismen der Anästhesie

Iatrogenic Injury

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