Brain damage after coronary artery bypass grafting.

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Abstract
CORONARY ARTERY bypass grafting (CABG) is associated with a risk for neurological complications. The overall incidence of serious focal neurological complications, such as stroke or transient ischemic attacks, has been reported to be 3% to 5%.1-3 In a subgroup of high-risk patients, severe postoperative neurological complications can be as high as 8.4%.4 Subtle, but detectable, postoperative changes in cognitive function are considered even more frequent.3 For the assessment of the neurological damage following CABG, several techniques have been evaluated, including quantitative electroencephalography,5 measurements of the S100 protein,6 auditory-evoked potentials,7 transcranial Doppler ultrasonography,8 and magnetic resonance imaging (MRI).5,7,9-11 Diffusion-weighted (DW) MRI and 1H-magnetic resonance spectroscopy (MRS) are new magnetic resonance techniques that, to our knowledge, have not been systematically used to study patients after CABG. Diffusion-weighted MRI allows for sensitive and early detection of cerebral ischemia within minutes of onset.12,13 Diffusion-weighted MRI can detect a significant proportion of focal ischemic brain damage in patients with an unchanged neurological examination result.14 Magnetic resonance spectroscopy allows for a limited in vivo assessment of cerebral metabolism.15 We aimed to prospectively evaluate brain damage following CABG using DW-MRI and MRS and to correlate the findings with clinical and neuropsychological data.