ABSTRACT
Brain injury and the neurological morbidity related to such injury are important phenomena observed in infants who have undergone cardiac surgery. The absolute number of surviving infants with brain injury and subsequent neurological morbidity in this setting can be expected to increase. The magnitude of the problem relates directly to the large number of affected infants. Although our understanding of the neurology of brain injury associated with infant cardiac surgery is incomplete, the major neurological deficits observed have been seizures, choreoathetosis, bilateral motor deficits, and hemiparesis. The neuropathological substrates for the neurological features just described are understood only incompletely. The central theme in pathogenesis appears to be ischemia. Parasagittal cerebral injury, a second topographically restricted lesion related to generalized ischemia, is characterized neuropathologically by injury to superomedial aspects of the cerebral cortex and subcortical white matter and is bilateral and generally symmetric. Focal cerebral infarction presumably is the basis for the spastic hemiparesis that subsequently is evident in some infants.
