A Tourette-like syndrome following cardiopulmonary bypass and hypothermia: MRI volumetric measurements.
Identifieur interne : 004D50 ( Ncbi/Curation ); précédent : 004D49; suivant : 004D51A Tourette-like syndrome following cardiopulmonary bypass and hypothermia: MRI volumetric measurements.
Auteurs : H S Singer [États-Unis] ; P S Dela Cruz ; M T Abrams ; S C Bean ; A L ReissSource :
- Movement disorders : official journal of the Movement Disorder Society [ 0885-3185 ] ; 1997.
English descriptors
- KwdEn :
- Attention Deficit Disorder with Hyperactivity (etiology), Brain (pathology), Brain (radionuclide imaging), Cardiopulmonary Bypass (adverse effects), Child, Humans, Hypothermia, Induced (adverse effects), Magnetic Resonance Imaging, Male, Obsessive-Compulsive Disorder (etiology), Tomography, Emission-Computed, Single-Photon, Tourette Syndrome (etiology), Tourette Syndrome (physiopathology), Tourette Syndrome (radionuclide imaging).
- 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.
DOI: 10.1002/mds.870120417
PubMed: 9251079
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pubmed:9251079Le document en format XML
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<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, Johns Hopkins Hospital, Baltimore, MD 21287-8811, USA.</nlm:affiliation>
<country xml:lang="fr">États-Unis</country>
<wicri:regionArea>Department of Neurology, Johns Hopkins Hospital, Baltimore, MD 21287-8811</wicri:regionArea>
<placeName><region type="state">Maryland</region>
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<author><name sortKey="Dela Cruz, P S" sort="Dela Cruz, P S" uniqKey="Dela Cruz P" first="P S" last="Dela Cruz">P S Dela Cruz</name>
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<author><name sortKey="Abrams, M T" sort="Abrams, M T" uniqKey="Abrams M" first="M T" last="Abrams">M T Abrams</name>
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<author><name sortKey="Reiss, A L" sort="Reiss, A L" uniqKey="Reiss A" first="A L" last="Reiss">A L Reiss</name>
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<sourceDesc><biblStruct><analytic><title xml:lang="en">A Tourette-like syndrome following cardiopulmonary bypass and hypothermia: MRI volumetric measurements.</title>
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<affiliation wicri:level="2"><nlm:affiliation>Department of Neurology, Johns Hopkins Hospital, Baltimore, MD 21287-8811, USA.</nlm:affiliation>
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<author><name sortKey="Dela Cruz, P S" sort="Dela Cruz, P S" uniqKey="Dela Cruz P" first="P S" last="Dela Cruz">P S Dela Cruz</name>
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<author><name sortKey="Abrams, M T" sort="Abrams, M T" uniqKey="Abrams M" first="M T" last="Abrams">M T Abrams</name>
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<series><title level="j">Movement disorders : official journal of the Movement Disorder Society</title>
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<term>Brain (radionuclide imaging)</term>
<term>Cardiopulmonary Bypass (adverse effects)</term>
<term>Child</term>
<term>Humans</term>
<term>Hypothermia, Induced (adverse effects)</term>
<term>Magnetic Resonance Imaging</term>
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<term>Tourette Syndrome (etiology)</term>
<term>Tourette Syndrome (physiopathology)</term>
<term>Tourette Syndrome (radionuclide imaging)</term>
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<keywords scheme="MESH" qualifier="etiology" xml:lang="en"><term>Attention Deficit Disorder with Hyperactivity</term>
<term>Obsessive-Compulsive Disorder</term>
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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>
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