Magnetic resonance imaging of the brain in infants and children before and after cardiac surgery: a prospective study

Article Abstract:

New techniques have allowed children and infants with congenital heart defects to be successfully treated by open-heart surgery. However, neurologic damage following open heart surgery in children is unknown, although in adults, cardiac surgery-related neurologic damage has been reported to occur in between 7 and 9 percent of all cases. A group of 15 children and infants with congenital heart disease was assessed for neurologic abnormalities following open heart surgery. Morphologic (structural) examinations were performed using magnetic resonance imaging (MRI) scanning techniques before and after heart surgery. All of the subjects had moderate hypothermic cardiopulmonary bypass surgery performed. After open-heart surgery, morphological changes were noted in the group; ventriculomegaly (enlargement of the ventricles) and dilatation of the subarachnoid spaces in the brain were observed in 5 out of the 15 patients. Four of the subjects developed subdural hematomas (mass of blood, often a clot, between the brain and the dura membrane) after the surgery; one patient suffered a postoperative infarction. The incidence of neurological changes in these children, as detected by postoperative MRI, is disturbing. It is recommended that pediatric cardiologists and neurologists work together to prevent brain injuries which may have a serious and long-term impact upon these children. (Consumer Summary produced by Reliance Medical Information, Inc.)

Usage, Causes of, Surgery, Heart, Brain, Magnetic resonance imaging, Brain damage, Heart surgery

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Cat-scratch disease: acute encephalopathy and other neurologic manifestations

Article Abstract:

Cat-scratch disease usually results from the scratch or bite of a healthy cat and causes swelling of the lymph nodes, fever and malaise which may persist for months. The central nervous system may also be affected. It is not known how cat-scratch involves the brain. A review is presented of 76 patients with neurologic complications of cat-scratch disease; 61 of these had encephalopathy (abnormal brain function). Average patient age was 10.1 years and almost twice as many males developed encephalopathy as females; cases of uncomplicated cat-scratch disease are almost equally distributed between male and female (54 percent male). Only half of the patients with encephalopathy had elevated temperature, 46 percent had convulsions and 40 percent showed combative behavior. Lethargy is common in both complicated and uncomplicated cat-scratch disease. Fourteen patients had evidence of cat-scratch disease upon biopsy. Various laboratory tests performed and central nervous system imaging studies were not diagnostic. All patients recovered without residual neurologic deficit, and 76 percent recovered within 1 to 12 weeks. Treatment included control of convulsions and respiratory support. Use of common antibiotics (given to about half the patients) was not found to be effective. (Consumer Summary produced by Reliance Medical Information, Inc.)

Care and treatment, Complications and side effects, Cat-scratch disease

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