Vedel AG, et al. - In this secondary analysis of the perfusion pressure cerebral infarcts trial, researchers evaluated potential variations in domain-specific patterns of cognitive deterioration between cardiac surgery patients allocated to a mean arterial pressure of either 70-80 mm Hg (high-target) or 40-50 mm Hg (low-target) during cardiopulmonary bypass. They also determined if postoperative cognitive dysfunction (POCD) was related to brain lesions detected on diffusion-weighted magnetic resonance imaging (DWI). Of overall 197 patients randomized, complete DWI datasets were available for 89 in the low-target group and 80 in the high-target group, and complete data for an assessment of cognitive function at discharge were available with 92 and 80 patients, respectively. The groups demonstrated comparable domain-specific patterns of POCD. Findings revealed a significant link between DWI-positive brain lesions and POCD. Patients with DWI-positive brain lesions more frequently had POCD at discharge.