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Brain immaturity is associated with brain injury before and after neonatal cardiac surgery with high-flow bypass and cerebral oxygenation monitoring 

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Presentation on theme: "Brain immaturity is associated with brain injury before and after neonatal cardiac surgery with high-flow bypass and cerebral oxygenation monitoring "— Presentation transcript:

1 Brain immaturity is associated with brain injury before and after neonatal cardiac surgery with high-flow bypass and cerebral oxygenation monitoring  Dean B. Andropoulos, MD, MHCM, Jill V. Hunter, MD, David P. Nelson, MD, Stephen A. Stayer, MD, Ann R. Stark, MD, E. Dean McKenzie, MD, Jeffrey S. Heinle, MD, Daniel E. Graves, PhD, Charles D. Fraser, MD  The Journal of Thoracic and Cardiovascular Surgery  Volume 139, Issue 3, Pages (March 2010) DOI: /j.jtcvs Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

2 Figure 1 A, Preoperative sagittal T1-weighted magnetic resonance image (MRI) of a 35-week gestational-age infant with hypoplastic left heart syndrome. Extensive white matter injury (WMI) is present in the periventricular areas (arrows). B, Preoperative axial proton-density T2-weighted image. Again note extensive WMI (arrows). C, Seven-day postoperative T1 sagittal MRI after Norwood stage I palliation. Note new intraparenchymal/intraventricular hemorrhage and infarction in the left peritrigonal region (arrow). D, Proton density T2-weighted image. Again note WMI and new hemorrhage (arrow). This patient had the single highest injury score on both preoperative and postoperative MRI injury scale, at 11 points preoperatively and 21 points postoperatively. Brain total maturity score was 8, equivalent to a 33-week gestational age infant. (Refer to MRI scoring table in Appendix 3.) The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

3 Figure 2 A, New postoperative infarction (white arrow) in a patient after Norwood stage I palliation for hypoplastic left heart syndrome, on T1-weighted sagittal imaging in the right posterior frontoparietal deep white matter, and extending to the lentiform nucleus, measuring 5 × 7mm. B, T2-weighted image. C, Matching area of restricted diffusion (white arrow). The Journal of Thoracic and Cardiovascular Surgery  , DOI: ( /j.jtcvs ) Copyright © 2010 The American Association for Thoracic Surgery Terms and Conditions

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