Cerebral Damage Before and After Cardiac Surgery (Developments in Critical Care Medicine and Anaesthesiology (27))

Despite numerous reports of cerebral damage in cardiac surgery, the subject has not been given the attention it requires. This book, with a preface by Torkel Aberg, will remedy that situation. The causes and incidence of pre- and post-operative cerebral damage are considered in the first section. Cardiac surgery patients frequently have __preoperative__ cerebral impairment, not suprising when one considers the impaired circulation from a damaged heart and the brain's prodigious need for blood. Moreover, several perioperative aspects of surgical procedures have been considered as possible causes of cerebral dysfunction, for example: microbubbles, toxic by-products, non-pulsatile blood flow. The second section describes how __imaging techniques__ (CT scan, MRI, regional cerebral blood flow imaging), and __functional assessment__ techniques. (PET scan, EEG, BEAM and evoked potentials) can be used to measure cerebral damage. In the third section, psychometric and neuropsychological techniques are used to assess impaired mental abilities (abstract thinking, language, memory, visuo-spatial ability, mental flexibility, attention and concentration). The final section explores the relationship between cerebral dysfunction and psychopathology (several types of depression, anxiety, and aspects of organic brain syndrome, delirium and dementia). Front Matter....Pages i-xvii Front Matter....Pages 1-1 The causes of pre-operative psychopathology in cardiac surgery patients....Pages 3-14 Cardiac surgery and acute neurological injury....Pages 15-36 Prevalence and causes of cerebral complications in cardiac surgery....Pages 37-46 Perfusion related parameters affecting cerebral outcome after cardiac surgery....Pages 47-56 The role of the surgical team in minimizing postoperative cerebral dysfunction....Pages 57-67 The causes of postoperative cerebral damage....Pages 69-81 Central nervous risk factors in cardiac surgery....Pages 83-98 Front Matter....Pages 99-99 Neuropsychological methods for evaluating regional brain dysfunction....Pages 101-111 Computerized EEG in cardiac surgery....Pages 113-126 Clinical electroencephalographic assessment of cerebral impairment....Pages 127-145 The promise and the peril of topographic mapping of quantified brain electrical activity: Technical and interpretive considerations affecting validity....Pages 147-162 Real time multichannel quantitative EEG monitoring....Pages 163-181 Front Matter....Pages 183-183 Impairment in basic cognitive functioning: attention, concentration, mental flexibility....Pages 185-193 The use of neuropsychological tests as criteria of brain dysfunction in cardiac surgery research....Pages 195-202 Neuropsychological dysfunction before and after cardiac surgery....Pages 203-216 Front Matter....Pages 217-217 Emotional reactions to cardiac surgery....Pages 219-237 Adjustment disorder in cardiac surgery patients....Pages 239-248 Major depression and adjustment disorder with depressed mood or depressive disorders....Pages 249-254 Organic mental disorders in cardiac surgery....Pages 255-263 Back Matter....Pages 265-270