Incidence Of Cerebral Complications Research Articles

Cerebral Complications Following Facial Autologous Fat Graft Injection: A Systematic Review and Meta-analysis.

With the increasing use of autologous fat (AF) grafting in plastic surgery, the occurrence of complications has garnered the attention from plastic surgeons. This study aims to estimate the cerebral complications following facial AF graft injection objectively and systematically with newly published literature. A comprehensive literature search was conducted systematically on PubMed, Embase, Web of Science, Cochrane, and ClinicalTrials.gov for articles published between 2000 and 2023. A systematic review and meta-analysis were performed in accordance with PRISMA guidelines. A total of 11 articles comprising of 37 participants were included, all of which are case reports. For AF facial filling, the incidence rate of cerebral embolism among cases of cerebral and ocular embolism was found to be 60% (95% CI 0.41-0.79). The incidence of cerebral embolism presenting with initial symptoms of unconsciousness was 69% (95% CI 0.48-0.9), with limb movement disorders was 55% (95% CI 0.26-0.84), and with vision loss was 30% (95% CI 0.12-0.49). The incidence of cerebral embolism with ophthalmic artery occlusion was 36% (95% CI 0.20-0.53), compared to was 71% (95% CI 0.48-0.95) without ophthalmic artery occlusion. AF grafting is generally safe and minimally invasive. However, with its widespread use as facial injection filling for cosmetic enhancement, the incidence of cerebral complications, such as cerebral infarction, has also increased. It is imperative to properly manage high-risk factors for cerebral embolism during the perioperative period to prevent its occurrence. This journal requires that authors assign a level of evidence to each article. For a full description of these Evidence-Based Medicine ratings, please refer to the Table of Contents or the online Instructions to Authors www.springer.com/00266 .

Cerebral Ischemia after Stenting of Coarctation of the Aorta.

Percutaneous stenting angioplasty of native coarctation of the aorta is considered a low-risk procedure with high success rate. The incidence of cerebral complications, especially ischemic complications, is very low. We report a case of a 15-year-old boy who underwent a percutaneous stenting angioplasty for a coarctation of the aorta and developed a cerebral infraction 4 hours after the procedure.

Repair of Extensive Thoracoabdominal Aortic Aneurysm with a Tetrafurcate Graft: Midterm Results of 63 Cases

The objective is to present a method for maintaining the spinal cord blood supply and our midterm results for using a tetrafurcate graft in extensive thoracoabdominal aortic aneurysm (TAAA) repair. From August 2003 to October 2007, we used a tetrafurcate graft to perform repairs to TAAAs of Crawford extent II in 63 consecutive patients. The mean age of this group of patients was 39.98 +/- 10.62 years, and 46 (73%) of them were male. All of the procedures were performed under profound hypothermia with a short interval of circulatory arrest. T6 to T12 intercostal arteries were reconstructed as a "neo-intercostal artery" (N-IA) and were connected to an 8-mm sidearm of the graft to maintain the spinal cord blood supply. Visceral arteries were joined into a patch and were anastomosed to the end of the main graft. The left renal artery was anastomosed to an 8-mm sidearm or joined to the patch. The other 10-mm sidearms were anastomosed to iliac arteries. With 100% follow-up, the early-mortality rate was 7.94%. The incidence of cerebral complications was 9.52%. Temporary paraplegia was observed in 2 patients, and paraparesis occurred in 1 patient. Pulmonary complication was the most common morbidity in this group (25.40%). Two patients with Marfan syndrome had N-IA artery pseudoaneurysms during follow-up. The mean survival time of this group was 50.64 +/- 2.13 months, with survival rates of 92.06% after 1 year, 88.38% after 2 years, and 86.11% after 3 years. The N-IA may play an important role in spinal cord protection, and N-IA pseudoaneurysm should be avoided in Marfan syndrome patients. The use of a tetrafurcate graft is a reliable method for TAAA repair, with satisfactory midterm results.

Predictive factors for mortality and cerebral complications in arteriosclerotic aneurysm of the aortic arch

Background. The incidence of cerebral complications is high in patients with aortic arch aneurysm. Methods. Between December 1977 and December 1995, 246 patients with arteriosclerotic arch aneurysm underwent operation. Thirty-nine patients had an aneurysm involving the entire arch, 193 had only distal arch aneurysm, and 14 had arch aneurysm extending to the descending aorta. Eighty-seven patients underwent replacement of the total arch, 85 had replacement of only the distal arch, 14 had simultaneous replacement of the descending aorta, 45 had patch repair, and 15 had thromboexclusion. Selective cerebral perfusion was used in 112 patients and partial bypass in 58 in the earlier series of patients, but deep hypothermic circulatory arrest with retrograde cerebral perfusion technique was exclusively applied in the most recent 76 patients. Results. There were 50 (20%) early deaths and 37 (19%) late deaths. Postoperative stroke was found in 26 (11%) patients of which 13 (50%) died. Mutual predictive factors for postoperative mortality and stroke were earlier series, preoperative chronic renal failure, ruptured aneurysm, arch clamping during procedure, and using partial cardiopulmonary bypass. Among 129 patients operated on during the most recent 5 years, early mortality and incidence of stroke decreased to 14.7% and 6.9%, respectively. Conclusions. Results of operations for arteriosclerotic aneurysms of the transverse aortic arch in 246 patients during a period of 17 years have been improving but are still not satisfactory.

Analysis of factors affecting complications of carotid ligation.

A study of 156 patients subjected to common carotid ligation in the treatment of head and neck carcinoma was made to investigate the influence of selected factors on cerebral complications. In the analysis complications were grouped as death or coma; death, coma, hemiplegia or monoplegia; and transitory cerebral symptoms. Primary independent variables included method of occlusion (abrupt, gradual); duration of occlusion; and collateral circulation via the external carotid artery (intact, ligated external carotid artery). Death or coma occurred in 24 cases (15.4%) and complications including death, coma, hemiplegia or monoplegia occurred in 47 cases (30.1%). Although no statistically significant difference between abrupt and gradual occlusion cases was noted, the incidence of cerebral complications was significantly lower for the group with gradual carotid occlusions performed over 13 days (6.3%) than for those with abrupt occlusions or gradual occlusions performed in less than five days. The incidence of death or coma following carotid artery occlusion was 10.5% in cases with an intact external carotid artery, as against 25.5% in those with a ligated external carotid artery, a statistically significant difference. Cerebral complications occurred within 48 hours after carotid occlusion in 35 of 47 cases (74.5%) in which complications developed. In the remaining 12 cases (25.5%) complications developed after 48 hours. There was no difference between abrupt and gradual occlusion cases in the incidence of complications after 48 hours.

Neurologic complications of angiography for cerebrovascular disease.

A recent study reported a 12.2% incidence of cerebral complications (5.2% permanent) after cerebral angiography in 147 patients. Because this was markedly different from our experience, we initiated a retrospective study of 301 patients who had undergone cerebral angiography for hemisphere transient ischemia or amaurosis fugax. There was only a 1.3% rate of transient complications (none permanent) in our patients. The benefits of cerebral angiography in patients with suspected cerebrovascular occlusive disease overwhelm the small potential risk of the procedure.

Zur Frage psychischer und neurologischer Störungen bei Herzoperationen

The following problems are discussed as the result of an own investigation done with 150 patients after cardiac surgery: 1. the differences in incidence of cerebral complications understood as 2. a probleme of qualitatively different psychopathological and neurological syndromes. 3. Causes and relationship between the clinical stages of heart-disease and neuropsychiatric complications with special regard to the question 4. congenital heart-disease versus aquired heart-disease. 5. The role of extracorporeal circulation. 6. Remarks on the role of microembolism associated with open cardiac surgery. 7. Hereditary factors as the cause for specific psychopathological reactions.