Brain Infarction ; surgery ; Brain Ischemia ; surgery ; Cerebral Revascularization ; Humans ; Middle Cerebral Artery ; surgery ; Postoperative Period ; Retrospective Studies ; Temporal Arteries ; surgery

Adult ; Cerebral Infarction ; etiology ; Humans ; Intraoperative Complications ; etiology ; Lung Neoplasms ; pathology ; surgery ; Male

Humans ; Infarction, Middle Cerebral Artery/surgery* ; Thrombectomy ; Thrombosis/etiology* ; Stents/adverse effects* ; Treatment Outcome

Objective To evaluate the effect of surgical reconstruction of extracranial vertebral artery and to summarize the experience. Methods The clinical data of 15 patients undergoing surgical reconstruction of extracranial vertebral artery from September 2018 to June 2022 were collected.The operation methods,operation duration,intraoperative blood loss,operation complications,and relief of symptoms were retrospectively analyzed. Results Eleven patients underwent vertebral artery (V1 segment) to common carotid artery transposition,two patients underwent endarterectomy of V1 segment,two patients underwent V3 segment to external carotid artery bypass or transposition.The operation duration,intraoperative blood loss,and blocking time of common carotid artery varied within 120-340 min,50-300 ml,and 12-25 min,with the medians of 240 min,100 ml,and 16 min,respectively.There was no cardiac accident,cerebral hyperperfusion syndrome,cerebral hemorrhage or lymphatic leakage during the perioperative period.One patient suffered from cerebral infarction and three patients suffered from incomplete Horner's syndrome after the operation.During the follow-up (4-45 months,median of 26 months),there was no anastomotic stenosis,new cerebral infarction or cerebral ischemia. Conclusion Surgical reconstruction of extracranial vertebral artery is safe and effective,and individualized reconstruction strategy should be adopted according to different conditions.
Humans ; Vertebral Artery/surgery* ; Blood Loss, Surgical ; Retrospective Studies ; Brain Ischemia ; Cerebral Infarction

Humans ; Cardiac Catheterization ; Treatment Outcome ; Heart Septal Defects, Atrial/surgery* ; Cerebral Infarction ; Septal Occluder Device

Improved operative, anesthetic, and cardiopulmonary bypass (CPB) techniques have significantly reduced postoperative complications; however, neurologic disorders remain a serious complication after open heart surgery. Possible explanations for neurologic complications are microembolism from CPB, decreased cerebral perfusion pressure due to intraoperative hypotension and unexpected metabolic changes. Amomg these, seizure has low incidence and Todd`s paralysis after open heart surgery is extremely rare. Todd's paralysis is a complication of a seizure due to neuronal exhaustion mimicking large cerebral infarction after open heart surgery.
Cardiopulmonary Bypass ; Cerebral Infarction* ; Heart* ; Hypotension ; Incidence ; Nervous System Diseases ; Neurons ; Paralysis* ; Perfusion ; Postoperative Complications ; Seizures ; Thoracic Surgery*

OBJECTIVETo establish a stable and feasible rabbit model of cardiopulmonary bypass (CPB) in acute cerebral embolism phase for studying the effects of CPB on brain tissues and the timing of surgical intervention of acute cerebral embolism.

METHODSFifty-four rabbits were randomized into group A (n=18) to receive CPB without middle cerebral artery occlusion (MCAO) and group B to undergo CPB at 24 h (group B1, n=18) or 1 week (group B2, n=18) after MCAO. Through a supraorbital margin approach, electrocoagulation was carried out to occlude the main stem of the left MCA under direct vision to establish MCAO. Magnetic resonance imaging (MRI) was performed at both 24 h and 1 week after MCAO, and the severity of cerebral embolization was evaluated. CPB was established by cannulation of the ascending aorta and the right atrium through a median sternotomy incision. MRI was performed at 2 h after CPB to observe the brain tissues.

RESULTSMCAO was successfully established in groups B1 and B2, and all the rabbits survived after MCAO. In both groups A and B, MRI examination detected no cerebral hemorrhage or new embolism 2 h after CPB.

CONCLUSIONSWe have established a stable and feasible CPB model in rabbits with acute cerebral embolism to allow study of the mechanisms of CPB-related organ damage and its interventions.

Animals ; Cardiopulmonary Bypass ; Disease Models, Animal ; Electrocoagulation ; Female ; Infarction, Middle Cerebral Artery ; etiology ; physiopathology ; Magnetic Resonance Imaging ; Male ; Middle Cerebral Artery ; surgery ; Rabbits ; Random Allocation

Left ventricular thrombus is mainly caused by anterior myocardial infarction or severe cardiac wall dysfunction of the apex, and is rarely caused by a complication of acute myocarditis. A 12-year-old female who developed symptoms of motor dysphasia and incomplete hemiparesis of the right side was admitted to the hospital. The brain MRI taken on the day of her admission showed acute cerebral infarction in the left basal ganglia and the frontoparietal lobe. The echocardiogram showed a movable thrombus, which was 19x28 mm sized and located in the apex of the left ventricle. So in order to prevent further thromboembolic event we performed open cardiac surgery via the atrium and removed the thrombus of the left ventricle. After the removal of the thrombus her symptoms improved and she was discharged from the hospital. Thrombus formation in acute viral myocarditis are considered to be related with endocardial injury and blood flow stasis. Treatment with anticoagulants in left ventricular thrombosis may not be effective and may even cause a major thromboembolism. When the thrombus is laminar and fixed, one should consider anticoagulant therapy. But if the thrombus is pedunculated and movable, which means that there are higher possibilities of major embolism or there may be already one, one should consider surgical removal. We report a 12-year-old girl who required surgical removal of a left ventricular thrombus caused by acute viral myocarditis.
Anticoagulants ; Aphasia ; Basal Ganglia ; Brain ; Cerebral Infarction ; Child ; Embolism ; Female ; Heart Ventricles ; Humans ; Magnetic Resonance Imaging ; Myocardial Infarction ; Myocarditis* ; Paresis ; Thoracic Surgery ; Thromboembolism ; Thrombosis*

Adult ; Carcinoma, Acinar Cell ; surgery ; Carotid Artery, Internal ; Cerebral Infarction ; etiology ; Embolism, Cholesterol ; etiology ; Female ; Head and Neck Neoplasms ; surgery ; Humans ; Postoperative Complications

OBJECTIVE: To explore the incidence and risk factors of readmission of elderly patients with hip fracture after hip hemiarthroplasty. METHODS: A retrospective analysis of 237 elderly hip fracture patients who underwent hip hemiarthroplasty from February 2015 to October 2020 were performed. According to the readmission status of the patients at 3 months postoperatively, the patients were divided into readmission group (39 cases)and non-readmission group(198 cases). In readmission group, there were 7 males and 32 females with an average age of(84.59±4.34) years old, respectively, there were 34 males and 164 females with average age of (84.65±4.17) years old in non-readmission group. The general information, surgical status, hip Harris score and complications of patients in two groups were included in univariate analysis, and multivariate Logistic regression was used to analyze independent risk factors of patients' readmission. RESULTS: The proportion of complications(cerebral infarction and coronary heart disease) in readmission group was significantly higher than that of non-readmission group (P<0.05), and intraoperative blood loss in readmission group was significantly higher than that of non-readmission group(P<0.05). Harris score of hip joint was significantly lower than that of non-readmission group(P<0.05). The proportion of infection, delirium, joint dislocation, anemia and venous thrombosis in readmission group were significantly higher than that of non-readmission group (all P<0.05). Multivariate Logistic regression analysis showed that the risk factors for readmission of elderly patients with hip fracture after hip hemiarthroplasty included cerebral infarction, infection, delirium, dislocation, anemia and venous thrombosis (all P<0.05). CONCLUSION The complications of the elderly patients who were readmission after hip hemiarthroplasty for hip fractures were significantly higher than those who were non-readmission. Cerebral infarction, infection, delirium, dislocation, anemia and venous thrombosis are risk factors that lead to patient readmission. Corresponding intervention measures can be taken clinically based on these risk factors to reduce the incidence of patient readmissions.
Aged ; Aged, 80 and over ; Arthroplasty, Replacement, Hip ; Cerebral Infarction/surgery* ; Delirium ; Female ; Femoral Neck Fractures/surgery* ; Hemiarthroplasty/adverse effects* ; Hip Fractures/surgery* ; Humans ; Joint Dislocations/surgery* ; Male ; Patient Readmission ; Retrospective Studies ; Risk Factors ; Treatment Outcome