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The brain and cardiac surgery. Causes of neurological complications and their prevention
  1. JOHN BOWLER

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    The brain and cardiac surgery. Causes of neurological complications and their prevention. Edited by stanton p newman andmichael jg harrison. (pp 343, £70.00). Published by Harwood Academic Publishers, The Netherlands, 2000. ISBN 90 5702 476 4.

    This book offers a description of the neurological syndromes that may occur after cardiac surgery, including both central and peripheral complications. This is followed by information on neuropsychological outcome, quality of life, imaging, and neuropathology. The information supplied is reasonably comprehensive. The data on prognosis are a little thin, but there is probably enough here to advise patients, and the relatives of patients who have sustained damage, for the information to be useful, although it would be available from other sources. The one complication that I did not see mentioned was hypertensive encephalopathy, which I have seen in a teenage patient with apparently “normal” blood pressure after cardiac transplantation, but who for many years preoperatively had a systolic blood pressure of about 70.

    The next section of the book deals with markers of cerebral injury and patient monitoring techniques including both EEG and cardiac emboli; it subsequently moves on to management techniques. These two parts of the book would be of very limited interest to neurologists, and would be of greatest interest to anaesthetists. The information is fairly comprehensive although it deals with prevention, part of the subtitle of the book, implicitly rather than explicitly and similarly identification of high risk patients is covered very sparsely indeed.

    Neurologists will be familiar from other environments with the vast majority of the neurological material in this volume. It will probably be of greatest use to anaesthetists and cardiac surgeons, for whom it would be a useful introduction to the neurological consequences of cardiac surgery.

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