Microbleeds during heart surgery

[Agian]

Recently had MRI of the head. All normal. However, they found 4 tiny areas of iron staining. These means sometime in the past the tip of a capillary burst and bled a little. When the blood is absorbed, what is left is a tiny bit of iron, which is picked up on the MRI. The radiologist told me it might be because I had high blood pressure as a young man, or head trauma. I thought it might've been when I landed head first into a concrete cricket pitch at school, or punches in the head when I did kick boxing. He told me they wouldn't be from Warfarin, as it would be a bigger deal, and besides they're old.

I read somewhere that microbleeds can occur when we're on cardiopulmonary bypass during surgery. Anyone else had/heard of this?

 

[pellicle]

Nope

But it's unsurprising that as we get better medical imaging we'll learn more new and interesting things.

In our favor the body (and the brain too) is surprisingly resilient, adapting to changes forced by minor injuries and major ones alike.

But thanks for posting, I've got something more to read up about.

 

[Freddie]

YES! I was told by my neologist that these microbleeds are very common after being on the by-pass machine and they are nothing to worry about and that he was not concerned about them.

 

[tom in MO]

Well who knows, those microbleeds could be the cause of "pump head syndrome" which does and doesn't exist Did your neologist (or is it neurologist?) say what about the by-pass machine causes microbleeds in your brain?

 

[Superman]

I don't know about on the brain, but I've got iron staining like crazy on my shins. Usually get a whole new batch after a high level of hiking and or walking in high heat on vacation.

Probably a whole new thread - but anyone else on warfarin get this?

 

[pellicle]

I don't know about on the brain, but I've got iron staining like crazy on my shins. Usually get a whole new batch after a high level of hiking and or walking in high heat on vacation.

Dunno if it's ecchymosis

My wife's grandfather had that on the backs of his hands. I don't recall if he was on warfarin or not

 

[Superman]

Dunno if it's ecchymosis

My wife's grandfather had that on the backs of his hands. I don't recall if he was on warfarin or not

Backs of hands I always heard we’re called liver spots. I’ve never looked into why. I’ll have to do that.

Yep. Liver spots. Incorrectly attributed to problems with the liver in the past. Caused by sun exposure as we age. Skin isn’t as resilient. Generally appear on hands, arms, and shoulders in people over 50.

My my cardiologist diagnosed mine as iron staining. I do get little spots of bright red blood on my lower legs when hiking in the heat and sun. When they go away, they leave the staining behind.

 

[pellicle]

Hi

Backs of hands I always heard we’re called liver spots. I’ve never looked into why. I’ll have to do that.

Yep. Liver spots. Incorrectly attributed to problems with the liver in the past. Caused by sun exposure as we age. Skin isn’t as resilient. Generally appear on hands, arms, and shoulders in people over 50.

thanks for doing that dig ... I'm wondering if they're the same thing because:
* he lived in Finland and I doubt had much sun on his hands as say an Australian. He commonly wore gloves when working (cos at -10C and lower one tends to do that)
* his spots were more "patches" as they were 3 and 4cm in diameter ...

so it may be a different thing.

I'll look into it.

Anyway, glad you're out nailing it with exersize and living life. Myself I've got a belt to change in my Yamaha T-Max ...



well and the sheaves too ... due to some rather interesting damage done under the stewardship of the last owner ...

... of course I'll probably bleed to death (a few times) doing this cos "I'm on warfarin"

;-)

 

[Agian]

YES! I was told by my neologist that these microbleeds are very common after being on the by-pass machine and they are nothing to worry about and that he was not concerned about them.

Did you have an MRI Freddie, which showed them up?!
That would nail it for me.
N=2

 

[Freddie]

Sorry for the misspelling - I should know better than to respond to a post 10min after waking up.
Yes Tom in MO it was my neurologist who told me this and my family doctor also confirmed that the mirco-bleeds were cause by the by-pass-machine.
Again: yes I did have a MRI done and a CT with dye. Don't recall if the MRI was done with dye. It was one of those two tests that showed the micro-bleeds.

 

[Agian]

Thanks Freddie, that's useful info for me.

 

[Agian]

Hi guys,

Freddie you mentioned you also got microbleeds. I've been advised to do a follow-up MRI in a year. I say bs to that.

How many microbleeds they find on your MRI Freddie. Are there any symptoms?

Your neurologist told you they're common. Did he tell you how common?
Did you get a follow-up MRI, because I don't wanna. I suspect you were just told to forget about it.

May I ask why you saw the neurologist?

 

[Agian]

I found these. Do they look legit, Pel?

https://www.ncbi.nlm.nih.gov/pubmed/20588015

http://www.onlinejacc.org/content/60...plement/B255.2

"New embolic cerebral insults and microbleeds detected by MRI were seen both patient groups (TAVI+surgical AVR). Patients after surgical AVR showed more microbleeds, whereas patients after TAVI showed more embolic ischemic insults."

It looks like 60% of peeps having AVR get microbleeds.

 

[pellicle]

Hi

I found these. Do they look legit, Pel?

well ****, that made me think ... (been working on under floor heating and learning how to use my new IR imager)

http://www.onlinejacc.org/content/60...plement/B255.2
...
It looks like 60% of peeps having AVR get microbleeds.

at least in their study ... but (assuming I understood the earlier link) its not sure what is the significance of this.

However it would seem to put some credence on some mechanism to explain the observation of post perfusion syndrome and perhaps even other psychological after surgery effects like depression.

Its worth noting their study cohort weren't "young"

18 male, 30 female, mean age 81±5 years

I assume its down to that TAVI has the advantage of being less time with the heart stopped ...

I'd countenance this with the fact that we know the brain is quite "adaptable" and if there are any pathways damaged then I'd conjecture it helps find the way around it.

Very interesting stuff

 

[Freddie]

Hi guys,

Freddie you mentioned you also got microbleeds. I've been advised to do a follow-up MRI in a year. I say bs to that.

How many microbleeds they find on your MRI Freddie. Are there any symptoms?

Your neurologist told you they're common. Did he tell you how common?
Did you get a follow-up MRI, because I don't wanna. I suspect you were just told to forget about it.

May I ask why you saw the neurologist?

I believe they found 4 or 5 microbleeds and no I don't have any symptoms.
The reason for seeing a neurologist....a long story. I was experiencing a constant dizziness, CT and MRI was done within the hospital and the results where given to some asshole female neurologist in the hospital who said I had a stroke and I needed to go on high blood pressure medication. After seeing me, I heard her say the exact same thing to another patient (there was only a curtain separating the examining rooms) she sounded like a tape recorder.

I then went to my GP and my cardiologist with the results who both said 'that micrbleeds are common after being on the heart/lung bypass machine and there was nothing in the MRI & CT scans to indicate a stroke or the cause of my dizziness and you don't need to go on HP meds'. It was my GP then referred me to a neurologist because I was so upset.

This was like 8 years ago, dizziness stop after 2 weeks and NO I haven't had a follow-up MRI nor has it ever been mentioned again by any of my doctors.

 

[Agian]

Aw, we're like brothers Freddie. You were messed around by this as well.

I saw a neurologist, but mine started spinning crap, telling me he would have expected to see embolic debris, or some ****.

I'm 49 btw, I'm guessing you're a similar age by the dialect. They say it's more common as we age, but an MRI done in 2013, after temporary vision loss, didn't show them. I had the avr in 2016, so it would make sense it was the operation. The radiology report said to do another MRI in 12 months. I didn't want to do another MRI, because every time I have an investigation I get worked up. I was upset like you, you saw three docs who said the same thing. I saw a physician, who reassured me and explained why it was the operation.

 

[Freddie]

At the time I just assumed the asshole female was a neurologist, which is why my GP referred me to another one to get a second opinion.

Thank - you for the compliment on the age hahaha, but soon to be 8yrs older than yourself.

But hey, I've always wanted a younger brother since I'm the youngest female in the family (no worries, rotfl it's all good)

 

[Agian]

I thought you was a dude LMAO

 

[Freddie]

So do most ppl lol, it's all good and hopefully it put a smile on your face

 

[Agian]

Sounds like you were the same age as me when you had the MRI.
They found four on mine.
Gender is a societal construct, anyway, so we can be sisters.