Document Detail


A Tourette-like syndrome following cardiopulmonary bypass and hypothermia: MRI volumetric measurements.
MedLine Citation:
PMID:  9251079     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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.
Authors:
H S Singer; P S Dela Cruz; M T Abrams; S C Bean; A L Reiss
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Publication Detail:
Type:  Case Reports; Journal Article; Research Support, Non-U.S. Gov't; Research Support, U.S. Gov't, P.H.S.    
Journal Detail:
Title:  Movement disorders : official journal of the Movement Disorder Society     Volume:  12     ISSN:  0885-3185     ISO Abbreviation:  Mov. Disord.     Publication Date:  1997 Jul 
Date Detail:
Created Date:  1997-10-14     Completed Date:  1997-10-14     Revised Date:  2007-11-14    
Medline Journal Info:
Nlm Unique ID:  8610688     Medline TA:  Mov Disord     Country:  UNITED STATES    
Other Details:
Languages:  eng     Pagination:  588-92     Citation Subset:  IM    
Affiliation:
Department of Neurology, Johns Hopkins Hospital, Baltimore, MD 21287-8811, USA.
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MeSH Terms
Descriptor/Qualifier:
Attention Deficit Disorder with Hyperactivity / etiology
Brain / pathology,  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*,  physiopathology,  radionuclide imaging
Grant Support
ID/Acronym/Agency:
HD 25806/HD/NICHD NIH HHS; HD 31715/HD/NICHD NIH HHS; MH 00142/MH/NIMH NIH HHS

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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