Neurosurgical treatment of cerebrovascular complications of heart surgeries and interventions

Abstract

AIm: Intracerebral haematoma and brain ischaemia are rare life-threatening complications of cardiovascular surgery. The aim of this study is to present the experience with the neurosurgical treatment of patients with cerebrovascular complications of heart surgery. mATERIAl and mEThods: Patients with brain ischaemia or intracerebral haematoma in the acute phase after heart surgery or invasive intervention operated on between 2002 and 2011 were reviewed. There were 3 patients with middle cerebral artery infarction requiring decompressive craniectomy (2 males, 1 female; mean age 54.3 years) and 5 patients with intracerebral haematoma (3 males, 2 females; mean age 55 years). The type of surgery for intracerebral haematoma was selected individually preferring minimally invasive techniques: stereotactic aspiration (2 patients), neuroendoscopy (1 patient), stereotactic craniotomy (1 patient) or classical craniotomy (1 patient). REsulTs:The results of decompressive craniectomy were unsatisfactory: GOS 1, 3 and 4 in 1 patient each. The results of surgery for intracerebral haematoma were GOS 5 in 1 patient, GOS 4 in 2 patients, and lethal in 2 patients. CoNClusIoN:Minimally invasive neurosurgery techniques appear to be beneficial for selected patients with intracerebral haematoma after heart surgeries even when considering the limited number of patients. Decompressive craniectomy should be considered strictly individually.