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Postoperative cognitive dysfunction in children

Julia K Gunn, John Beca, Rodney W Hunt, Michelle Goldsworthy, Christian P Brizard, Kirsten Finucane, Susan Donath, Lara S Shekerdemian
OBJECTIVE: Historical cohort studies have reported adverse neurodevelopment following cardiac surgery during early infancy. Advances in surgical techniques and perioperative care have coincided with updating of neurodevelopmental assessment tools. We aimed to determine perioperative risk factors for impaired neurodevelopment at 2 years following surgery for congenital heart disease (CHD) in early infancy. DESIGN AND PATIENTS: We undertook a prospective longitudinal study of 153 full-term infants undergoing surgery for CHD before 2 months of age...
June 6, 2016: Archives of Disease in Childhood
Gregory S Matte, Kevin R Connor, Hua Liu, James A DiNardo, David Faraoni, Frank Pigula
Gaseous microemboli (GME) are known to be delivered to the arterial circulation of patients during cardiopulmonary bypass (CPB). An increased number of GME delivered during adult CPB has been associated with brain injury and postoperative cognitive dysfunction. The GME load in children exposed to CPB and its consequences are not well characterized. We sought to establish a baseline of arterial limb emboli counts during the conduct of CPB for our population of patients requiring surgery for congenital heart disease...
March 2016: Journal of Extra-corporeal Technology
Cindy S T Aun, Catherine McBride, Anna Lee, Angel S C Lau, Raymond C K Chung, Chung Kwong Yeung, Kelly Y C Lai, Tony Gin
Due to the neurotoxicity effects of general anesthesia (GA) and sedatives found in animal studies, there is a general recommendation to avoid nonurgent surgical procedures requiring anesthesia in children younger than 3 years of age. The aim of this study was to determine the incidence of anesthesia-related postoperative cognitive dysfunction (POCD) on the first day (Day 1) and at 6 weeks after elective noncardiac surgery in school-age children.This was a prospective cohort study of 118 children undergoing GA and 126 age-matched controls of school children aged 5 to 12 years...
April 2016: Medicine (Baltimore)
Yaoqin Hu, Shanshan Shi, Xiwang Liu, Zhiyong Hu, Wenfang Huang, Dongpi Wang, Jianguo Xu, Baoli Cheng, Xiangming Fang, Qiang Shu
Accumulation of β-amyloid (Aβ) plaques is a pathological hallmark of Alzheimer disease. Aβ levels in animals and adults were reported to be associated with postoperative cognitive dysfunction (POCD). Our goal was to determine the plasma levels of Aβ in infants and young children after cardiac surgery with cardiopulmonary bypass (CPB).Forty-two infants and young children aged from 1 to 35 months undergoing cardiac surgery with general anesthetics were prospectively enrolled from January to June 2014 at a tertiary medical center...
February 2016: Medicine (Baltimore)
Janna Mittnacht, Daniela Choukair, Carolin Kneppo, Romuald Brunner, Peter Parzer, Matthias Gorenflo, Markus Bettendorf
BACKGROUND: Transient thyroid dysfunction occurs in children after cardiopulmonary bypass (CPB). We demonstrated significant benefits of acute postoperative tri-iodothyronine (T3) treatment for recovery and myocardial function. Now we report the long-term neurodevelopment of these children. METHODS: Twenty-eight children (70% of the original study population) could be recruited for a follow-up examination (median age 10.7 years, range 10-19.6 years) retaining the double-blind, randomized, placebo-controlled protocol...
2015: Hormone Research in Pædiatrics
Mohammad-Hasan Abdollahi, Khalil Foruzan-Nia, Mostafa Behjati, Babak Bagheri, Mehdi Khanbabayi-Gol, Shahla Dareshiri, Alireza Pishgahi, Rafie Zarezadeh, Nazgol Lotfi-Naghsh, Ainaz Lotfi-Naghsh, Mohammad Naghavi-Behzad
BACKGROUND: Post-operative fever is a common complication of cardiac operations, which is known to be correlated with a greater degree of cognitive dysfunction 6 weeks after cardiac surgery. The aim of the present study was to examine efficacy and safety of single dose intravenous Paracetamol in treatment of post-operative fever in children undergoing cardiac surgery. MATERIALS AND METHODS: In this randomised, double-blind, placebo-controlled clinical trial, 80 children, aged 1-12 years, presenting for open heart surgery were entered in the trial and randomly allocated into two groups: Placebo and Paracetamol...
September 2014: Nigerian Medical Journal: Journal of the Nigeria Medical Association
Keith Millar, Adrian W Bowman, Deirdre Burns, Paul McLaughlin, Tony Moores, Neil S Morton, Toni Musiello, Ewan Wallace, Alyson Wray, Richard R Welbury
BACKGROUND: Postoperative cognitive dysfunction (POCD) is well established in adults but has been underinvestigated in children. As day-case procedures are increasingly common, it is important to establish whether children suffer significant POCD. Pediatric POCD has been associated with several intravenous and inhalation anesthetics, but isoflurane has not been studied. As evidence indicates superior recovery after propofol, the study compared POCD after propofol or isoflurane anesthesia...
February 2014: Paediatric Anaesthesia
A M Ovezov, M A Lobov, M V Panteleeva, A V Lugovoĭ, P S Miatchin, I E Gus'kov
UNLABELLED: The aim of the study was to assess the possibility and effectiveness of hopaten acid use for early postoperative cognitive dysfunction correction in children of school age. MATERIALS AND METHODS: In compliance with inclusion and exclusion criteria, totally 40 children of school age (7-16 years old, ASA status I-II) with surgical pathology: (varicocele, cryptorchidism, inguinal hernia) were included A comperative assessment of neuropsychic status during pre - and postoperative are period in children, operated under propofol-fentanyl total intravenous anesthesia (TIVA) was conducted All patients were randomized to the control (without cepebroprotection 1st group, 20 children) and experimental (using cepebroprotection with hopaten acid within 1 month after the operation, 2nd group, 20 children) groups...
May 2012: Anesteziologiia i Reanimatologiia
Diane Schretzman Mortimer
Posterior fossa syndrome can occur after neurosurgical resections of childhood posterior fossa tumors, such as medulloblastomas. Posterior fossa syndrome is characterized by transient mutism, emotional lability, cognitive deficits, weakness, ataxia, and cranial nerve dysfunction. Symptoms generally appear 1 to 3 days after surgery and persist for months to years. Neuroscience nurses play an integral role in helping affected children and their families through the diagnosis, treatment, and sequelae of this frightening syndrome...
August 2011: Journal of Neuroscience Nursing: Journal of the American Association of Neuroscience Nurses
Virginia Frisk, Lorna S Jakobson, Sharon Unger, Daniel Trachsel, Karel O'Brien
BACKGROUND/PURPOSE: Although there has been a marked improvement in the survival of children with congenital diaphragmatic hernia (CDH) in the past 2 decades, there are few reports of long-term neurodevelopmental outcome in this population. The present study examined neurodevelopmental outcomes in 10- to 16-year-old CDH survivors not treated with extracorporeal membrane oxygenation (ECMO). METHODS: Parents of 27 CDH survivors completed questionnaires assessing medical problems, daily living skills, educational outcomes, behavioral problems, and executive functioning...
July 2011: Journal of Pediatric Surgery
Concezio Di Rocco, Daniela Chieffo, Benedetta Ludovica Pettorini, Luca Massimi, Massimo Caldarelli, Gianpiero Tamburrini
INTRODUCTION: The aim of the present study was to prospectively investigate if a correlation might exist between preoperative and postoperative neurological conditions, neuroradiological/intraoperative findings and results of a complete neuropsychological evaluation in children with posterior fossa medulloblastomas and astrocytomas. MATERIALS AND METHODS: Of the 65 children admitted at the Pediatric Neurosurgery of the UCSC of Rome between January 2005 and October 2009, 41 were selected; the only two exclusion criteria were represented by age under 24 months and severe neurological conditions, seen that in both cases it would not have been a possible reliable evaluation...
September 2010: Child's Nervous System: ChNS: Official Journal of the International Society for Pediatric Neurosurgery
Wakoto Matsuda, Hiroyoshi Akutsu, Shinya Miyamoto, Shozo Noguchi, Takashi Tsunoda, Mamoru Sasaki, Akira Matsumura
A 13-year-old right-handed boy sustained minor head trauma in a traffic accident. Computed tomography of the head showed no injuries, but revealed an arachnoid cyst in the left middle fossa. Single photon emission computed tomography revealed relatively decreased cerebral blood flow (CBF) in the left frontal and temporal lobes compared with the contralateral regions. The Wechsler Intelligence Scale for Children-Revised (WISC-R) test showed full scale intelligence quotient (IQ) was normal, but also a discrepancy between verbal IQ and performance IQ...
2010: Neurologia Medico-chirurgica
Robert E Elliott, Stephen A Sands, Russell G Strom, Jeffrey H Wisoff
OBJECT: Controversy persists concerning the optimal treatment of craniopharyngiomas in children, and no standard outcome metric exists for comparison across treatment modalities, nor is there one that adequately reflects the multisystem dysfunction that may arise. METHODS: The authors retrospectively analyzed the records of 86 consecutive children who underwent a uniform treatment paradigm of attempted radical resection performed by a single surgeon. Excluding 3 perioperative deaths and 3 patients with inadequate follow-up, 80 children (34 girls and 46 boys; mean age 9...
April 2010: Neurosurgical Focus
Hyo Jung De Smet, Hanne Baillieux, Peggy Wackenier, Mania De Praeter, Sebastiaan Engelborghs, Philippe F Paquier, Peter P De Deyn, Peter Mariën
The posterior fossa syndrome (PFS) consists of transient cerebellar mutism, cognitive symptoms, and neurobehavioral abnormalities that typically develop in children following posterior fossa (PF) tumor resection. The pathophysiological substrate of the syndrome remains unclear. We investigated eight children of whom five presented with a variety of clinically relevant non-motor language symptoms associated with cognitive and behavioral disturbances after PF tumor resection. Four children developed transient cerebellar mutism followed by dysarthric speech...
November 2009: Neuropsychology
Vijendra Kumar, Sanjay Behari, Rohit Kumar Singh, Manoj Jain, Awadhesh K Jaiswal, Vijendra K Jain
PURPOSE: Pediatric colloid cysts (CC) have a congenital origin, and yet, there are very few studies focussing exclusively on their occurrence in the pediatric population. Pediatric CC has been associated with more aggressive clinical and radiological patterns than their adult counterparts. In this study, undertaken on children with anterior third ventricular CC, excised using the interhemispheric transcallosal approach, the characteristic clinicoradiological features and management options are studied...
March 2010: Acta Neurochirurgica
Takakazu Kawamata, Kosaku Amano, Yasuo Aihara, Osami Kubo, Tomokatsu Hori
Although many authors have described treatment strategies for craniopharyngiomas, the optimal treatment of craniopharyngiomas remains controversial. This study aimed to define an adequate surgical strategy for craniopharyngiomas by reviewing the long-term functional performance of patients treated by current and past treatment modalities. Fifty-five patients with longer than 5 years of follow-up were selected for the present long-term study. The duration of follow-up ranged from 5.5 to 33 years (median, 14...
January 2010: Neurosurgical Review
Ułbołgan A Fesenko
BACKGROUND: Surgery and anaesthesia may account for postoperative complications including cognitive impairment. The purpose of the study was to assess the influence of general anaesthetics on children's memory and effectiveness of piracetam for prevention of postoperative cognitive dysfunction. METHODS: The study included patients receiving different kinds of anaesthesia for various surgical procedures, randomly allocated to two groups. According to immediate postoperative treatment, the study group received intravenous piracetam 30 mg kg(-1) and the control group--placebo...
January 2009: Anestezjologia Intensywna Terapia
Martijn Tilanus, Aart Klijn, Pieter Dik, Laetitia de Kort, Tom de Jong
OBJECTIVE: To study the clinical and urodynamic parameters of children who developed bladder diverticula (BD) after ureteral reimplantation. MATERIALS AND METHODS: We have reviewed records of 15 children who underwent ureteric reimplantation, possibly with diverticulectomy between January 1998 and October 2004, who postoperatively developed BD and compared the results with 25 patients, surgically treated for primary vesicoureteric reflux (VUR) without BD development after reimplantation...
2009: Neurourology and Urodynamics
U Lopez, W Habre, M Van der Linden, I A Iselin-Chaves
Adults who experience intra-operative awareness can develop disturbing long-lasting after-effects, such as daytime anxiety, sleep disturbances, nightmares, flashbacks and, in the worst case, a post-traumatic stress disorder (PTSD). It is unknown whether intra-operative awareness has a similar psychological impact in children. We designed the present study in order to evaluate the incidence of psychological symptoms in children who had either confirmed or possible intra-operative awareness. Attempts were made to locate 11 children who had been identified in a previous study, approximately 1 year following their experience...
May 2008: Anaesthesia
Kristina Malmgren, Ingrid Olsson, Elisabeth Engman, Roland Flink, Bertil Rydenhag
Epilepsy surgery has been questioned for patients with low IQ, since a low cognitive level is taken to indicate a widespread disturbance of cerebral function with unsatisfactory prognosis following resective surgery. The prevalence of epilepsy in patients with cognitive dysfunction is, however, higher than in the general population and the epilepsy is often more severe and difficult to treat. It is therefore important to try to clarify whether IQ predicts seizure outcome after resective epilepsy surgery. The Swedish National Epilepsy Surgery Register, which includes data on all epilepsy surgery procedures in Sweden since 1990, was analysed for all resective procedures performed 1990-99...
February 2008: Brain: a Journal of Neurology
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