|
Sign In to gain access to subscriptions and/or personal tools.
|
Long-Term MRI Changes in Brain After Pediatric Open Heart Surgery
Geoffrey Miller, MD
Section of Pediatric Neurology Baylor College of Medicine, Texas Children's Hospital
Alexander C. Mamourian, MD
Department of Radiology, Milton S. Hershey Medical Center, Pennsylvania State University, Hershey, PA
Johanna R. Tesman, PhD
Department of Pediatrics, Milton S. Hershey Meidical Center, Pennsylvania State University, Hershey, PA
Barry G. Baylen, MD
Department of Pediatrics, Milton S. Hershey Meidical Center, Pennsylvania State University, Hershey, PA
John L. Myers, MD
Department of Surgery Milton S. Hershey Medical Center, Pennsylvania State University, Hershey, PA
We performed magnetic resonance imaging (MRI) on the brain and neurologic examinations on 23 children after open heart surgery for congenital heart disease. Twenty children also had psychometric assessments. Examinations were performed at a mean age of 66 months (range, 26 to 180 months). Age at operation was less than 1 month in 43% and more than 6 months in 45%. Abnormal scans were found in 17 (74%) and showed diffuse findings consistent with hypoxic-ischemic encephalopathy, with or without areas of cortical infarction; focal cortical infarction alone; and (in one patient) callosal agenesis and abnormal neuronal migration. Normal IQ and neurologic examinations were found in all six of those who had a normal MRI, and five of six children with changes consistent with focal cortical infarction without diffuse change had a normal neurologic examination. Cerebral palsy and mental retardation was common in the group with diffuse abnormality (in eight of nine children), and this was more likely to occur in those who underwent prolonged (> 45 minutes) hypothermic circulatory arrest and operation during early infancy (P = .004). Focal cortical findings without diffuse changes were more likely in those who underwent open heart surgery without hypothermic circulatory arrest and were older than 6 months at operation, and these children were less likely to have frank neurodevelopmental sequelae. Thus, in our population, focal cortical lesions were common after open heart surgery, and, in addition, diffuse brain abnormality on MRI plus neurologic sequelae were common after prolonged hypothermic circulatory arrest. (J Child Neurol 1994;9:390-397).
Journal of Child Neurology, Vol. 9, No. 4,
390-397 (1994)
DOI: 10.1177/088307389400900411
 CiteULike  Connotea  Del.icio.us  Digg  Reddit  Technorati What's this?
This article has been cited by other articles:
|
|
|
|
 
T. Domi, D. S. Edgell, B. W. McCrindle, W. G. Williams, A. K. Chan, D. L. MacGregor, A. Kirton, and G. A. deVeber
Frequency, Predictors, and Neurologic Outcomes of Vaso-occlusive Strokes Associated With Cardiac Surgery in Children
Pediatrics,
December 1, 2008;
122(6):
1292 - 1298.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
S. P Miller and P. S McQuillen
Neurology of congenital heart disease: insight from brain imaging
Arch. Dis. Child. Fetal Neonatal Ed.,
November 1, 2007;
92(6):
F435 - F437.
[Full Text]
[PDF]
|
|
|
|
|
|
|
A. Sarajuuri, E. Jokinen, R. Puosi, M. Eronen, L. Mildh, I. Mattila, L. Valanne, and T. Lonnqvist
Neurodevelopmental and neuroradiologic outcomes in patients with univentricular heart aged 5 to 7 years: Related risk factor analysis
J. Thorac. Cardiovasc. Surg.,
June 1, 2007;
133(6):
1524 - 1532.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
F. L. Hanley
Religion, politics...deep hypothermic circulatory arrest
J. Thorac. Cardiovasc. Surg.,
November 1, 2005;
130(5):
1236 - 1236.
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. J. Scallan
Cerebral injury during paediatric heart surgery: perfusion issues
Perfusion,
July 1, 2004;
19(4):
221 - 228.
[Abstract]
[PDF]
|
|
|
|
|
|
|
K. K. Galli, R. A. Zimmerman, G. P. Jarvik, G. Wernovsky, M. K. Kuypers, R. R. Clancy, L. M. Montenegro, W. T. Mahle, M. F. Newman, A. M. Saunders, et al.
Periventricular leukomalacia is common after neonatal cardiac surgery
J. Thorac. Cardiovasc. Surg.,
March 1, 2004;
127(3):
692 - 704.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
K. J. Griffin, T. D. Elkin, and C. J. Smith
Academic Outcomes in Children with Congenital Heart Disease
Clinical Pediatrics,
June 1, 2003;
42(5):
401 - 409.
[Abstract]
[PDF]
|
|
|
|
|
|
|
W. T. Mahle, F. Tavani, R. A. Zimmerman, S. C. Nicolson, K. K. Galli, J. W. Gaynor, R. R. Clancy, L. M. Montenegro, T. L. Spray, R. M. Chiavacci, et al.
An MRI Study of Neurological Injury Before and After Congenital Heart Surgery
Circulation,
September 24, 2002;
106(12_suppl_1):
I-109 - I-114.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
M. A. Priestley, J. A. Golden, I. B. O'Hara, J. McCann, and C. D. Kurth
Comparison of neurologic outcome after deep hypothermic circulatory arrest with alpha-stat and pH-stat cardiopulmonary bypass in newborn pigs
J. Thorac. Cardiovasc. Surg.,
February 1, 2001;
121(2):
0336 - 343.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
J. F. Todaro, E. B. Fennell, S. F. Sears, J. R. Rodrigue, and A. K. Roche
Cognitive and Psychological Outcomes in Pediatric Heart Transplantation
J. Pediatr. Psychol.,
December 1, 2000;
25(8):
567 - 576.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
C. Limperopoulos, A. Majnemer, M. I. Shevell, B. Rosenblatt, C. Rohlicek, and C. Tchervenkov
Neurologic Status of Newborns With Congenital Heart Defects Before Open Heart Surgery
Pediatrics,
February 1, 1999;
103(2):
402 - 408.
[Abstract]
[Full Text]
|
|
|
|
|
|
|
K. Uzark, A. Lincoln, J. J. Lamberti, R. D. Mainwaring, R. L. Spicer, and J. W. Moore
Neurodevelopmental Outcomes in Children With Fontan Repair of Functional Single Ventricle
Pediatrics,
April 1, 1998;
101(4):
630 - 633.
[Abstract]
[Full Text]
[PDF]
|
|
|
|
|
|
|
G. Miller and B. G. Baylen
Early Neurologic Outcome After Open Heart Surgery on Young Infants-Reply
Arch Pediatr Adolesc Med,
May 1, 1996;
150(5):
561 - 561.
[Abstract]
[PDF]
|
|
|
|
|
|
|
G. Miller, J. R. Tesman, J. C. Ramer, B. G. Baylen, and J. L. Myers
Outcome After Open-Heart Surgery in Infants and Children
J Child Neurol,
January 1, 1996;
11(1):
49 - 53.
[Abstract]
[PDF]
|
|
|
|
|
|
|
M. Ali, P. Smith, J. Brannan, and K. Taylor
Cerebral monitoring during cardiopulmonary bypass
Perfusion,
January 1, 1996;
11(4):
299 - 312.
[PDF]
|
|
|
|
|
|
|
G. Miller, K. D. Eggli, C. Contant, B. G. Baylen, and J. L. Myers
Postoperative Neurologic Complications After Open Heart Surgery on Young Infants
Arch Pediatr Adolesc Med,
July 1, 1995;
149(7):
764 - 768.
[Abstract]
[PDF]
|
|
|
|
|
