Postoperative cognitive dysfunctions after cardiac surgery: the role of neurosurgery and cardiology

Postoperative cognitive dysfunction (POCD) is one of the key problems faced by patients after cardiac surgery, including coronary bypass surgery and heart valve surgery. POCD manifests itself in the form of disorders of memory, attention, executive functions and other aspects of cognitive activity, which significantly reduces the quality of life of patients and complicates rehabilitation. The authors set a number of tasks in their work: to consider the pathophysiological mechanisms underlying POCD, including ischemic brain damage, microembolism, inflammatory response and metabolic changes, as well as to study the features of an interdisciplinary approach to the diagnosis and treatment of POCD, combining the efforts of cardiologists, neurosurgeons and specialists in neurorehabilitation. The role of cardiology in the context of the issue under consideration is to prevent intraoperative complications, monitor cardiovascular function, and minimize the risk of strokes and hypoperfusion. Neurosurgery and neuromonitoring ensure the timely detection and correction of neurological complications, as well as the development of methods to protect the brain during surgery. The authors explore modern technologies such as intraoperative imaging, the use of neuroprotective drugs, and rehabilitation strategies aimed at restoring cognitive functions. Attention is paid to the prospects of personalized medicine and the importance of further research to optimize the treatment and prevention of POCD.