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Four decades ago, after on-pump coronary artery bypass graft surgery (CABG) was introduced for treating symptomatic coronary artery disease (CAD), operative mortality had continuously declined to below 5%.1-3 While the mortality had fallen, the operative morbidity had been rising as CABG gradually enrolled more complicated elderly cases with advanced CAD and co-morbidities.1-4 Among surgical morbidity, cerebral complications were the most devastating events, since they increased the length of stay, medical expense as well as hospital mortality.5-19 Although the available data showed the declining incidence of peri-operative CNS injury, the incidence of overt cases still varied from 2-7%.20, 21
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