A tourette‐like syndrome following cardiopulmonary bypass and hypothermia: MRI volumetric measurements
Identifieur interne : 002885 ( Istex/Corpus ); précédent : 002884; suivant : 002886A tourette‐like syndrome following cardiopulmonary bypass and hypothermia: MRI volumetric measurements
Auteurs : Singer ; Pablito S. Delacruz ; Michael T. Abrams ; S. Charles Bean ; Allan L. ReissSource :
- Movement Disorders [ 0885-3185 ] ; 1997-07.
English descriptors
- KwdEn :
Abstract
We present the case of an adolescent boy who developed a variety of simple and complex motor and vocal tics (Tourette‐like syndrome), along with inattentiveness and obsessive‐compulsive behaviors after cardiac surgery with cardiopulmonary bypass and profound hypothermia. A single photon emission computed tomography study 2 months after surgery showed reduced uptake in the left hemisphere and 2 years later a perfusion defect in the basal ganglia. Serial magnetic resonance imaging (MRI) studies were normal. Volumetric MRI studies were obtained 4 years after surgery and compared with published values for normal individuals and children with Tourette syndrome (TS), including subsets matched for age, sex, and handedness. Measurement of basal ganglia structures showed a right‐dominant asymmetry of the caudate and putamen, in part similar to findings previously reported in patients with TS. Other volumetric abnormalities included a >2‐SD reduction of cortical gray matter, a small decrease of total cerebral volume, and increase in cerebral white matter. Although a variety of neurological problems may occur after cardiopulmonary bypass, to our knowledge this case represents the first report of a chronic tic disorder following cardiac surgery with cardiopulmonary bypass and hypothermia.
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DOI: 10.1002/mds.870120417
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<affiliation>Johns Hopkins Hospital, Baltimore, Maryland</affiliation>
<description>Correspondence: Department of Neurology, Johns Hopkins Hospital, Harvey 811, 600 N. Wolfe St., Baltimore, MD 21287‐8811, U.S.A.</description>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Pablito S.</namePart>
<namePart type="family">DelaCruz</namePart>
<affiliation>Johns Hopkins Hospital, Baltimore, Maryland</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Michael T.</namePart>
<namePart type="family">Abrams</namePart>
<affiliation>Kennedy Krieger Institute, Baltimore, Maryland</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">S. Charles</namePart>
<namePart type="family">Bean</namePart>
<affiliation>A. I. DuPont Children's Hospital, Wilmington, Delaware, U.S.A.</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<name type="personal"><namePart type="given">Allan L.</namePart>
<namePart type="family">Reiss</namePart>
<affiliation>Johns Hopkins Hospital, Baltimore, Maryland</affiliation>
<affiliation>Kennedy Krieger Institute, Baltimore, Maryland</affiliation>
<role><roleTerm type="text">author</roleTerm>
</role>
</name>
<typeOfResource>text</typeOfResource>
<genre authority="originalCategForm">article</genre>
<originInfo><publisher>Wiley Subscription Services, Inc., A Wiley Company</publisher>
<place><placeTerm type="text">Hoboken</placeTerm>
</place>
<dateIssued encoding="w3cdtf">1997-07</dateIssued>
<dateCaptured encoding="w3cdtf">1996-09-19</dateCaptured>
<dateValid encoding="w3cdtf">1996-12-20</dateValid>
<copyrightDate encoding="w3cdtf">1997</copyrightDate>
</originInfo>
<language><languageTerm type="code" authority="rfc3066">en</languageTerm>
<languageTerm type="code" authority="iso639-2b">eng</languageTerm>
</language>
<physicalDescription><internetMediaType>text/html</internetMediaType>
<extent unit="figures">1</extent>
<extent unit="tables">2</extent>
<extent unit="references">32</extent>
</physicalDescription>
<abstract lang="en">We present the case of an adolescent boy who developed a variety of simple and complex motor and vocal tics (Tourette‐like syndrome), along with inattentiveness and obsessive‐compulsive behaviors after cardiac surgery with cardiopulmonary bypass and profound hypothermia. A single photon emission computed tomography study 2 months after surgery showed reduced uptake in the left hemisphere and 2 years later a perfusion defect in the basal ganglia. Serial magnetic resonance imaging (MRI) studies were normal. Volumetric MRI studies were obtained 4 years after surgery and compared with published values for normal individuals and children with Tourette syndrome (TS), including subsets matched for age, sex, and handedness. Measurement of basal ganglia structures showed a right‐dominant asymmetry of the caudate and putamen, in part similar to findings previously reported in patients with TS. Other volumetric abnormalities included a >2‐SD reduction of cortical gray matter, a small decrease of total cerebral volume, and increase in cerebral white matter. Although a variety of neurological problems may occur after cardiopulmonary bypass, to our knowledge this case represents the first report of a chronic tic disorder following cardiac surgery with cardiopulmonary bypass and hypothermia.</abstract>
<subject lang="en"><genre>Keywords</genre>
<topic>Tourette syndrome</topic>
<topic>Tics</topic>
<topic>Hypothermia</topic>
<topic>Cardiopulmonary bypass</topic>
<topic>Volumetric measurements</topic>
<topic>Obsessive‐compulsive disorder</topic>
<topic>Attention‐deficit hyperactivity disorder</topic>
</subject>
<relatedItem type="host"><titleInfo><title>Movement Disorders</title>
<subTitle>Official Journal of the Movement Disorder Society</subTitle>
</titleInfo>
<titleInfo type="abbreviated"><title>Mov. Disord.</title>
</titleInfo>
<subject><genre>article category</genre>
<topic>Brief Report</topic>
</subject>
<identifier type="ISSN">0885-3185</identifier>
<identifier type="eISSN">1531-8257</identifier>
<identifier type="DOI">10.1002/(ISSN)1531-8257</identifier>
<identifier type="PublisherID">MDS</identifier>
<part><date>1997</date>
<detail type="volume"><caption>vol.</caption>
<number>12</number>
</detail>
<detail type="issue"><caption>no.</caption>
<number>4</number>
</detail>
<extent unit="pages"><start>588</start>
<end>592</end>
<total>5</total>
</extent>
</part>
</relatedItem>
<identifier type="istex">CD899B2C5DF6EA5C490D1BB795AD587602867973</identifier>
<identifier type="DOI">10.1002/mds.870120417</identifier>
<identifier type="ArticleID">MDS870120417</identifier>
<accessCondition type="use and reproduction" contentType="copyright">Copyright © 1997 Movement Disorder Society</accessCondition>
<recordInfo><recordOrigin>Wiley Subscription Services, Inc., A Wiley Company</recordOrigin>
<recordContentSource>WILEY</recordContentSource>
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