A tourette‐like syndrome following cardiopulmonary bypass and hypothermia: MRI volumetric measurements
Identifieur interne : 005422 ( Main/Exploration ); précédent : 005421; suivant : 005423A tourette‐like syndrome following cardiopulmonary bypass and hypothermia: MRI volumetric measurements
Auteurs : Singer [États-Unis] ; Pablito S. Delacruz [États-Unis] ; Michael T. Abrams [États-Unis] ; S. Charles Bean [États-Unis] ; Allan L. Reiss [États-Unis]Source :
- Movement Disorders [ 0885-3185 ] ; 1997-07.
English descriptors
- KwdEn :
- Attention Deficit Disorder with Hyperactivity (etiology), Attention‐deficit hyperactivity disorder, Brain (pathology), Brain (radionuclide imaging), Cardiopulmonary Bypass (adverse effects), Cardiopulmonary bypass, Child, Humans, Hypothermia, Hypothermia, Induced (adverse effects), Magnetic Resonance Imaging, Male, Obsessive-Compulsive Disorder (etiology), Obsessive‐compulsive disorder, Tics, Tomography, Emission-Computed, Single-Photon, Tourette Syndrome (etiology), Tourette Syndrome (physiopathology), Tourette Syndrome (radionuclide imaging), Tourette syndrome, Volumetric measurements.
- MESH :
- adverse effects : Cardiopulmonary Bypass, Hypothermia, Induced.
- etiology : Attention Deficit Disorder with Hyperactivity, Obsessive-Compulsive Disorder, Tourette Syndrome.
- pathology : Brain.
- physiopathology : Tourette Syndrome.
- radionuclide imaging : Brain, Tourette Syndrome.
- Child, Humans, Magnetic Resonance Imaging, Male, Tomography, Emission-Computed, Single-Photon.
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.
Url:
DOI: 10.1002/mds.870120417
Affiliations:
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<front><div type="abstract" xml: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.</div>
</front>
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<name sortKey="Reiss, Allan L" sort="Reiss, Allan L" uniqKey="Reiss A" first="Allan L." last="Reiss">Allan L. Reiss</name>
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