The site of the Media Sphera Publishers contains materials intended solely for healthcare professionals.
By closing this message, you confirm that you are a certified medical professional or a student of a medical educational institution.

Login
EN
+7 (495) 482-4118
+7 (495) 482-0604
+8 800 250-18-12
  • (toll-free number for subscriptions)
    Mon-Fri from 10 a.m. to 6 p.m.

  • © 1998-2025
+7 (495) 482-43-29
EN
All journals
Journal
Year
Year
Search result: 0

Belov Yu.V.

RNTsKh im. akad. B.V. Petrovskogo RAMN

Medvedeva L.A.

FGBU "RNTsKh im. akad. B.V. Petrovskogo" RAMN

Katunina E.A.

Department of Neurology, Neurosurgery and Medical Genetics of the Pirogov Russian National Research Medical University of the Ministry of Health of the Russia, Moscow, Russia

Zagorulko O.I.

Petrovsky Russian Research Center of Surgery

Drakina O.V.

Clinic of Aortic and Cardiovascular Surgery of I.M. Sechenov First Moscow State Medical University, Moscow

Oĭstrakh A.S.

Otdelenie kardioreanimatsii Rossiĭskogo nauchnogo tsentra khirurgii im. akad. B.V. Petrovskogo RAMN, Moskva

Differential diagnosis of neurological conditions in cardiac patients on the first day after cardiac, ascending aortic and aortic arch surgery and repair of internal carotid arteries

Authors:

Belov Yu.V., Medvedeva L.A., Katunina E.A., Zagorulko O.I., Drakina O.V., Oĭstrakh A.S.

More about the authors

Journal: Pirogov Russian Journal of Surgery. 2019;(12): 5‑12

DOI: 10.17116/hirurgia20191215

Read: 2855 times

Download PDF (RU)
Contact the author
Table of contents

DIFFERENTIAL DIAGNOSIS OF NEUROLOGICAL CONDITIONS IN CARDIAC PATIENTS ON THE FIRST DAY AFTER CARDIAC, ASCENDING AORTIC AND AORTIC ARCH SURGERY AND REPAIR OF INTERNAL CAROTID ARTERIES
DIFFERENTIAL DIAGNOSIS OF NEUROLOGICAL CONDITIONS IN CARDIAC PATIENTS ON THE FIRST DAY AFTER CARDIAC, ASCENDING AORTIC AND AORTIC ARCH SURGERY AND REPAIR OF INTERNAL CAROTID ARTERIES

To cite this article:

Belov YuV, Medvedeva LA, Katunina EA, Zagorulko OI, Drakina OV, Oĭstrakh AS. Differential diagnosis of neurological conditions in cardiac patients on the first day after cardiac, ascending aortic and aortic arch surgery and repair of internal carotid arteries. Pirogov Russian Journal of Surgery. 2019;(12):5‑12. (In Russ.)
https://doi.org/10.17116/hirurgia20191215

Подписка 2025-2 (Pirogov Russian Journal of Surgery)
МСФ на ЯМ
Использование инфографики авторами научных работ
Mediasphera_Net
Close metadata
Recommended articles:
PANSS six-factor model. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(2):28-34
Cognitive impairment after major surgical operations. S.S. Korsakov Journal of Neurology and Psychiatry. 2025;(4-2):74-80

The review is devoted to analysis of current trends in interdisciplinary approach to the differential diagnosis of patients’ conditions on the first day after cardiac, ascending aortic and aortic arch surgery and repair of internal carotid arteries (neurological disorders, delirium, cognitive dysfunction, psycho-emotional disorders, postoperative sedation). This approach is valuable to determine the prognosis and timely treatment. The basic concepts reflecting the discussion between neurologists, cardiovascular surgeons, anesthetists, radiation diagnostics specialists and rehabilitators are summarized. The authors concluded that timely and correct differential diagnosis of the states on the first postoperative day using current tests and interdisciplinary approach to the treatment of patients with postoperative impaired consciousness or neurological/psycho-emotional dysfunction can improve their quality of life and efficiency of medical care.

Keywords:

postoperative cognitive dysfunction
impairment of consciousness
delirium
neurological disorders
neurocognitive deficit
psycho-emotional disorders

Authors:

Belov Yu.V.

RNTsKh im. akad. B.V. Petrovskogo RAMN

Medvedeva L.A.

FGBU "RNTsKh im. akad. B.V. Petrovskogo" RAMN

Katunina E.A.

Department of Neurology, Neurosurgery and Medical Genetics of the Pirogov Russian National Research Medical University of the Ministry of Health of the Russia, Moscow, Russia

Zagorulko O.I.

Petrovsky Russian Research Center of Surgery

Drakina O.V.

Clinic of Aortic and Cardiovascular Surgery of I.M. Sechenov First Moscow State Medical University, Moscow

Oĭstrakh A.S.

Otdelenie kardioreanimatsii Rossiĭskogo nauchnogo tsentra khirurgii im. akad. B.V. Petrovskogo RAMN, Moskva

List of references:

  1. Belov YuV, Medvedeva LA, Zagorulko OI, Charchyan ER, Drakina OV. Cognitive disorders in patients of the early and late period after carotid endarterectomy. Hirurgiya. 2018;12:5-12. (In Russ.) https://doi.org/10.17116/hirurgia20181215
  2. Head S, Kieser T, Falk V, Huysmans H, Kappetein A. Coronary artery bypass grafting: Part 1-the evolution over the first 50 years. European Heart Journal. 2013;34(37):2862-2872. https://doi.org/10.1093/eurheartj/eht330
  3. Fedulova SV. Monitoring cerebral blood flow during heart surgery under artificial blood circulation: Diss. kand. med. nauk. M. 2007. (In Russ.)
  4. Drakina OV. Surgical treatment of patients with brachiocephalic artery pathology: possibilities and prognostic value of neurocognitive testing: Diss. kand. med. nauk. M. 2018. (In Russ.)
  5. Katunina EA. The heterogeneity of vascular cognitive impairment and treatment issues. Nevrologiya, nejropsihiatriya, prihosomatika. 2015;7(3):62-69. (In Russ.) https://doi.org/10.14412/2074-2711-2015-3-62-69
  6. Ovezov AM, Lobov MA, Nadkina ED. Brain protection in the prevention of early postoperative cognitive dysfunction in total intravenous anesthesia. Lechashchii vrach. 2013;3:66-68. (In Russ.)
  7. Harris DN, Bailey SM, Smith PL, Taylor KM, Oatridge A, Bydder GM. Brain swelling in first hour after coronary artery bypass surgery. Lancet. 1993;342(8871):586-587. https://doi.org/10.1016/0140-6736(93)91412-f
  8. Collaborators NASCET: Beneficial effect of carotid endarterectomy in symptomatic patients with high grade carotid stenosis. N Engl J Mod. 1991;325:445-453. https://doi.org/10.1056/NEJM199108153250701
  9. Tungusov LS, Molochkov AV, Chernov II, Kondrat’ev DA, Motreva AP, Isaev MN, Ekimov SS, Tarasov DG. Perioperative strokes in elderly patients after coronary artery bypass grafting. Klinicheskaya i eksperimental’naya khirurgiya. 2016;4(4):22-26. (In Russ.)
  10. Alekyan G, Buziashvili YuI, Golukhova EZ. Large cardiac complications in percutaneous coronary interventions — predictors, causes, development, prevention methods and algorithms for therapeutic interventions. Kreativnaya kardiologiya. 2011;1:28-40. (In Russ.)
  11. Makkar RR, Fontana GP, Jilaihawi H, Kapadia S, Pichard AD, Douglas PS, Thourani VH, Babaliaros VC, Webb JG, Herrmann HC, Bavaria JE, Kodali S, Brown DL, Bowers B, Dewey TM, Svensson LG, Tuzcu M, Moses JW, Williams MR, Siegel RJ, Akin JJ, Anderson WN, Pocock S, Smith CR, Leon MB. Transcatheter aortic-valve replacement for inoperable severe aortic stenosis. N Engl J Med. 2012;366(18):1696-1704. https://doi.org/10.1056/NEJMoa1202277
  12. Smith CR, Leon MB, Mack MJ, Miller DC, Moses JW, Svensson LG, Tuzcu EM, Webb JG, Fontana GP, Makkar RR, Williams M, Dewey T, Kapadia S, Babaliaros V, Thourani VH, Corso P, Pichard AD, Bavaria JE, Herrmann HC, Akin JJ, Anderson WN, Wang D, Pocock SJ. Transcatheter versus surgical aortic-valve replacement in high-risk patients. N Engl J Med. 2011;364(23):2187-2198. https://doi.org/10.1056/NEJMoa1103510
  13. Belov YuV, Charchyan ER, Aksel’rod BA. Protection of the brain and internal organs during reconstructive interventions on the aortic arch: features of intraoperative tactics and monitoring. Patologiya krovoobrashcheniya i kardiohirurgiya. 2016;20(4):34-44. (In Russ.) https://doi.org/10.17116/hirurgia20181215
  14. Urbanski PP, Luehr M, Di Bartolomeo R, Diegeler A, De Paulis R, Esposito G, Bonser RS, Etz CD, Kallenbach K, Rylski B, Shrestha ML, Tsagakis K, Zacher M, Zierer A. Multicentre analysis of current strategies and outcomes in open aortic arch surgery: heterogeneity is still an issue. Eur J Cardiothorac Surg. 2016;50(2):249-255. https://doi.org/10.1093/ejcts/ezw055
  15. Caplan LR, Wong KS, Gao S, Hennerici MG. Is hypoperfusion an important cause of strokes? If so, how? Cerebrovasc Dis. 2006;21:145-153. https://doi.org/10.1159/000090791
  16. Miyamoto O, Auer RN. Hypoxia, hyperoxia, ischemia, and brain necrosis. Neurology. 2000;54:362-371. https://doi.org/10.1212/wnl.54.2.362
  17. Aldecoa C, Bettelli G, Bilotta F. European Society of Anaesthesiology evidence-based and consensus-based guideline on postoperative delirium. Eur J Anaesthesiol. 2017;34(4):192-214. https://doi.org/10.1097/EJA.0000000000000594
  18. Setters B, Solberg LM. Delirium. Prim Care. 2017;44(3):541-559. https://doi.org/10.1016/j.pop.2017.04.010
  19. Slooter AJ, Van De Leur RR, Zaal IJ. Delirium in critically ill patients. Handb Clin Neurol. 2017;141:449-466. https://doi.org/10.1016/B978-0-444-63599-0.00025-9
  20. Sandberg O, Gustafson Y, Brännström B, Bucht G. Prevalence of dementia, delirium and psychiatric symptoms in various care settings for the elderly. Scand J Soc Med. 1998;26(1):56-62.
  21. Bucht G, Gustafson Y, Sandberg O. Epidemiology of delirium. Demen Geriatr Cogn Disord. 1999;10(5):315-318. https://doi.org/10.1159/000017161
  22. Ely EW, Shintani A, Truman B, Speroff T, Gordon SM, Harrell FEJr, Inouye SK, Bernard GR, Dittus RS. Delirium as a predictor of mortality in mechanically ventilated patients in the intensive care unit. JAMA. 2004;291:1753-1762. https://doi.org/10.1001/jama.291.14.1753
  23. Connor D, English W. Delirium in critical care. Anaesthesia Tutorial of the Week. 2011.
  24. Dubois MJ, Bergeron N, Dumont M, Dial S, Skrobik Y. Delirium in an intensive care unit: a study of risk factors. Intens Care Med. 2001;27:1297-1304.
  25. Girard TD, Jackson JC, Pandharipande PP, Pun BT, Thompson JL, Shintani AK, Gordon SM, Canonico AE, Dittus RS., Bernard GR, Ely EW. Delirium as a predictor of long-term cognitive impairment in survivors of critical illness. Crit Care Med. 2010;38(7):1513-1520. https://doi.org/10.1097/CCM.0b013e3181e47be1
  26. Gunther ML, Morandi A, Ely WL. Pathophysiology of delirium in ICU. Crit. Care Clin. 2008;24(1):45-65. https://doi.org/10.1016/j.ccc.2007.10.002
  27. Khan BA, Zawahiri M, Campbell NL, Boustani MA. Biomarkers for delirium – a review. J Am Geriatr Soc. 2011;59: S256-S261. https://doi.org/10.1111/j.1532-5415.2011.03702.x
  28. Page V, Gough K. Management of delirium in the intensive care unit. Br J Hosp Med. 2010;71(7):372-376. https://doi.org/10.12968/hmed.2010.71.7.48994
  29. Mirski MA, Lewin JJ 3rd, Ledroux S, Thompson C, Murakami P, Zink EK, Griswold M. Cognitive improvement during continuous sedation in ritically ill, awake and responsive patients: the Acute Neurological ICU Sedation Trial (ANIST). Intensive Care Med. 2010;36(9):1505-1513. https://doi.org/10.1007/s00134-010-1874-9
  30. Sessler CN, Gosnell MS, Grap MJ, Brophy GM, O’Neal PV, Keane KA, Tesoro EP, Elswick RK. The Richmond Agitation-Sedation Scale: validity and reliability in adult intensive care unit patients. Am J Respir Crit Care Med. 2002;166(10):1338-1344. https://doi.org/10.1164/rccm.2107138
  31. Ouimet S, Riker R, Bergeron N, Cossette M, Kavanagh B, Skrobik Y. Subsyndromal delirium in the ICU: evidence for a disease spectrum. Intensive Care Med. 2007;33(6):1007-1013. https://doi.org/10.1007/s00134-007-0618-y
  32. Inouye SK, van Dyck CH, Alessi CA, Balkin S, Siegal AP, Horwitz RI. Clarifying confusion: the confusion assessment method. A new method for detection of delirium. Intern Med. 1990;113(12):941-948.
  33. Pandharipande P, Jackson J, Ely EW. Delirium: acute cognitive dysfunction in the critically ill. Curr Opin Crit Care. 2005;11(4):360-368.
  34. Trzepacz PT, Baker RW, Greenhouse J. A symptom rating scale for delirium. Psychiatry Res. 1988;23(1):89-97.
  35. Armstrong SC, Cozza KL, Watanabe KS. The misdiagnosis of delirium. Psychosom. 1997;38:433-439. https://doi.org/10.1016/S0033-3182(97)71420-8
  36. Nicholas LM, Lindsay BA. Delirium presenting with symptoms of depression. Psychosom. 1995;36:471-479. https://doi.org/10.1016/S0033-3182(95)71628-0
  37. Medvedeva LA, Zagorul’ko OI, Belov YuV. The results of early neurocognitive and neuropsychological testing in patients operated on the ascending aorta and the aortic arch. Z Hurnal im. NI Pirogova. 2014;8:53-58. (In Russ.)
  38. Selnes O, Grega M, Borowicz L, Royall R, McKhann G, Baumgartner W. Cognitive changes with coronary artery disease: a prospective study of coronary artery bypass graft patients and nonsurgical controls. The Annals of Thoracic Surg. 2003;75(5):1377-1386. https://doi.org/10.1016/s0003-4975(03)00021-3
  39. Bruce K, Yelland G, Smith J, Robinson S. Recovery of Cognitive Function After Coronary Artery Bypass Graft Operations. The Annals of Thoracic Surg. 2013;95(4):1306-1313. https://doi.org/10.1016/j.athoracsur.2012.11.021
  40. Fontes MT, Swift RC, Phillips-Bute B, Podgoreanu MV, Stafford- Smith M, Newman MF, Mathew JP. Neurologic Outcome Research Group of the Duke Heart Center. Predictors of cognitive recovery after cardiac surgery. Anesth Analg. 2013;116:435-442. https://doi.org/10.1213/ANE.0b013e318273f37e
  41. Newman M, Grocott H, Mathew J, White W, et al. Report of the Substudy Assessing the Impact of Neurocognitive Function on Quality of Life 5 Years After Cardiac Surgery Editorial Comment. Stroke. 2001;32(12):2874-2881. https://doi.org/10.1161/hs1201.099803
  42. Argunova YuA, Pomeshkina SA., Trubnikova OA. Cognitive dysfunction after coronary artery bypass surgery. Zhurnal nevrologii i psihiatrii. 2016;9:111-115. (In Russ.) https://doi.org/10.17116/jnevro201611691111-115
  43. Kellermann K, Jungwirth B. Avoiding stroke during cardiac surgery. Semin Cardiothorac Vasc Anesth. 2010;14:95-101. https://doi.org/10.1177/1089253210370902
  44. Newman MF, Mathew JP, Grocott HP. Central nervous system injury associated with cardiac surgery. Lancet. 2006;368:694-703. https://doi.org/10.1016/S0140-6736(06)69254-4
  45. Krenk L, Rasmussen LS, Kehlet H. New insights into the pathophysiology of postoperative cognitive dysfunction. Acta Anaesthesiol Scand. 2010;54:951-956. https://doi.org/10.1111/j.1399-6576.2010.02268.x
  46. Luriya AR. Basics of Neuropsychology. M.: Izdatel’stvo MGU, 2008. (In Russ.)
  47. Belov YuV, Medvedeva LA, Zagorulko OI, Charchyan ER, Drakina OV. Early and long-term cognitive disorders after carotid endarterectomy. Khirurgiia (Mosk). 2018;12:5-12. (In Russ.) https://doi.org/10.17116/hirurgia20181215
  48. Abildstrom H, Hogh P, et al. Cerebral blood flow and cognitive dysfunction after coronary surgery. Ann Thorac Surg. 2002;73:4:1174-1178.
  49. Akhutina TV, Melikyan ZA. Neuropsychological Testing: A Review of Current Trends. Klinicheskaya i special’naya psihologiya. 2012;2. (In Russ.) http://psyjournals.ru/psyclin/2012/n2/52599.shtml
  50. Horton DK, Hynan LS, Lacritz LH, Rossetti HC, Weiner MF, Cullum CM. An Abbreviated Montreal Cognitive Assessment (MoCA) for Dementia Screening. Clin Neuropsychol. 2015;29(4):413-425. https://doi.org/10.1080/13854046.2015.1043349
  51. Ciesielska N, Sokołowski R1, Mazur E, Podhorecka M, Polak-Szabela A, Kędziora-Kornatowska K. Is the Montreal Cognitive Assessment (MoCA) test better suited than the Mini-Mental State Examination (MMSE) in mild cognitive impairment (MCI) detection among people aged over 60? Meta-analysis. Psychiatr Pol. 2016;50(5):1039-1052. https://doi.org/10.12740/PP/45368
  52. Dubois B, Slachevsky A, Litvan I, Pillon B. The FAB: a Frontal Assessment Battery at bedside. Neurology. 2000;55(11):1621-1626. https://doi.org/10.1212/wnl.55.11.1621
  53. Belov YuV, Medvedeva LA, Zagorulko OI, Komarov RN, Drakina OV. Neurocognitive and psychoemotional disorders in patients with atherosclerosis of the internal carotid arteries in the postoperative period after carotid endarterectomy. Cardiology and cardiovascular surgery. 2015;4(8):37-42. (In Russ.) https://doi.org/10.17116/kardio20158437-42

Close metadata

Contact the author
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.

Email Confirmation

An email was sent to test@gmail.com with a confirmation link. Follow the link from the letter to complete the registration on the site.

Email Confirmation

Contact us
If you have any questions, complaints or suggestions, please use this feedback form.
Email
Message
The publishing house "Media Sphere" does not provide treatment services, does not give recommendations on contacting medical institutions and specific specialists, on the prescription of medicines and dietary supplements.
Submit Application

You can become an author of one of our magazines, send a request and we will consider it in during the day.

Name
Phone
E-mail
Message
Login
Registration
E-mail
Password
Forgot Password?

Log in to the site using your account in one of the services

Password recovery
E-mail
Login
Register

We use cооkies to improve the performance of the site. By staying on our site, you agree to the terms of use of cооkies. To view our Privacy and Cookie Policy, please. click here.