INTRODUCTION: Neurological complications (stroke) remain a devastating complication after cardiovascular surgical procedures despite advances in perioperative monitoring and management. The incidence of neurological complications related to cardiovascular surgeries is comparatively very high and associated with high morbidity and mortality. The aim of this study is to evaluate the overall incidence of neurological complication in adult as well as pediatric patients and various pattern of neurological injury on non-contrast computed tomography head (NCCT) associated with various types of cardiovascular surgeries. MATERIAL AND METHOD: We retrospectively analyzed all the NCCT heads of the postoperative cardiovascular surgery patients done in immediate and early post-operative period (<7days) who developed postoperative neurological deficitbetween April 2016 to February 2020. The medical records of all these cardiac surgery patients were analyzed for various variants like total number of patients who underwent cardiovascular surgeries, various types of cardiac surgery done during the study period, demographic information, associated co-morbidities, various types of neurological complications, post-operative data and various spectrum of CT findings in the brain. RESULT: Total 12896 adult and pediatric cardiac surgeries were performed at our institute. Out of these, 1115 patients (8.6%) underwent CT brain for suspected neurological injury. Total215 patients (1.6%) had positive finding on their NCCT head. Out of 215 patients, 148 (68.9%) were adult patients while 67 (31.1%) were pediatric patients. Total 156 (72.5%) patients had ischemic infract (stroke) while hemorrhagic lesion present in 59 patients (27.4%). The various types of positive CT scan findings were- 156 ischemic infarct (72.5%), 20 intra-parenchymal haemorrhages (9.3%), 16 subdural haemorrhage (7.4%), 15 sub-arachnoid haemorrhage (6.9%), 01 cerebrovascular thrombosis (0.4%) and 07 intra ventricular haemorrhage (3.2%). In adult patient pattern of ischemic infarct comprised middle cerebral artery territory in 42 patients (41.5%), posterior territory in 34 patients (33.6%), anterior cerebral territory in 7 patients (7.0%), multi-territory infracts in 11 patients (11.0%) and global ischemia in 6 patients (6.0%). Intra parenchymal hemorrhage was present in 17 patients (11.4%). In pediatric patient pattern of ischemic infarct included global hypoxic injury in 30 patients (54.5%), posterior cerebral artery territory in 9 patients (16.3%), middle cerebral artery territory in 8 patients (14.5%), multi-territory involvement in 5 patients (9.0%) and anterior cerebral artery territory in 3 patients (5.4%). In hemorrhage group 5 patients (7.4%) developed subarachnoid hemorrhage. CONCLUSION: In adult patients middle cerebral artery (MCA) territory infracts was common in infract group while Intra parenchymal hemorrhage (IPH) in hemorrhage group. In pediatric patient Global hypoxic injury (GHI) was common in infract group and Sub arachnoid hemorrhage (SAH) in hemorrhage group. Moreover, Non-contrast computed tomography (NCCT) of head is very useful in diagnosing early postoperative neurological complication in cardio-vascular surgeries and managing the complications accordingly.
