[The causes of cerebral complications in patients with ischemic heart disease following myocardial revascularization operations]. / Prichiny tserebral'nykh oslozhnenii u bol'nykh ishemicheskoi bolezn'iu serdtsa posle operatsii revaskuliarizatsii miokarda.

In the period from Jan. 1988 to Jan. 1991 operations for the formation of an aortocoronary shunt were carried out in 437 patients at the Department of Combined Affections of the Coronary and Peripheral Arteries, Bakulev Research Institute. In some cases the operation was combined with resection of a postinfarction aneurysm of the left ventricle. Cerebral complications developed in the postoperative period in 28 (6.4%) patients. Their analysis showed the prevalence of severe forms of consciousness disturbances: coma and comatose states were encountered in 85.7% of cases. The main causes of the complications were acute heart failure (64.3%) and arterial embolism (14.3%). In only one case concomitant affection of the branches of the aortic arch was found to be the main cause of the development of a transitory ischemic attack. It is concluded that the development of acute heart failure in the patients may sharply increase the incidence of neurologic complications.

[The risk of neurological complications following aortocoronary bypass in patients with multifocal atherosclerosis]. / Risk nevrologicheskikh oslozhnenii posle aortokoronarnogo shuntirovaniia u bol'nykh s mul'tifokal'nym aterosklerozom.

Since January 1988 till June 1990 145 patients with combined coronary and vascular pathology have been operated on. Concomitant damage of aortic arch branches was observed in 54 patients (37.2%), and aortocoronary bypass surgery was performed in 40 patients without correction of the carotid vascular bed pathology. These patients comprised the basic group, which was divided into two subgroups depending on the clinical pattern of the disease: subgroup I--18 asymptomatic patients (45.0%), subgroup II--22 patients (55.0%) with clinical signs of the disease. The basic group comprised 257 patients with CHD alone and no damages of the aortic arch branches. In the postoperative period 10 out of 40 patients of the basic group developed neurological complications: brain hypoxia, delirious syndrome (3 patients); brain hypoxia, pre-comatose condition (3 patients); brain hypoxia, comatose condition (2 patients); transitory ischemic attack (2 patients). No significant differences in the development of complications have been observed in patients of both subgroups. In the control group neurological complications developed in 9 out of 257 patients (3.5%). The comparison of reasons responsible for the onset of complications in both groups has shown that acute heart failure was significantly predominant (10%) in the basic group, as compared to control group (1.9%). It has been concluded that after aortocoronary bypass surgery the risk of neurological complications was higher in patients with the accompanying damage of the aortic arch branches than in patients with CHD alone; the onset of acute heart failure in the early postoperative period increases the risk of neurological complications in such patients.

[Compressed spectral EEG analysis of patients with acute cerebral circulatory disorders]. / Kompressovannyi spektral'nyi analiz EEG u bol'nykh s ostrym narusheniem mozgovogo krovoobrashcheniia.

The use of a new examination method -- compressed spectral analysis of EEGs by way of computerized Fourier's transformation -- is described. The method was used for examining 43 patients with cerebral stroke. Real-time comparisons of EEGs and data of their compressed spectral analysis were made in healthy subjects and patients with cerebral strokes of various character. Data on long-time on-line registration of the EEG spectrograms in patients with the cerebral strokes are presented, and the time course of the changes of those spectrograms in patients with the ischemic and hemorrhagic stroke is followed up. Prognostic criteria of the EEG spectrograms in cerebral strokes of various gravity are determined.