Extensive corpus callosum ischemia after coronary artery bypass grafting on extracorporeal circulation

Introduction: Heart surgery can be associated with adverse ischemic brain events. Case report: Here, we describe two patients who presented extensive infarction of the corpus callosum and of other brain watershed areas following coronary artery bypass grafting (CABG) on extracorporeal circulation (ECC). Discussion: Infarction of the corpus callosum is an extremely rare condition due to its abundant blood supply. Our findings are noteworthy since they diverge from classical brain watershed infarcts and from other cases of corpus callosum involvement. This suggests that in some cases, CABG surgery on ECC may be associated to a profound impairment of intracerebral circulation. However, it is also possible that the corpus callosum is particularly vulnerable to yet unknown metabolic modifications connected to ECC. Conclusions: Further studies are needed in order to investigate the complex response of brain circulation and metabolism during heart surgery with ECC.