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Complex stereotypies after right putaminal infarction: a case report
D M Maraganore1, A J Lees, C D Marsden
1Department of Neurology, Mayo Clinic, Rochester, Minnesota.
Abstract:
A 17-year-old boy is described who experienced circling behavior interrupting his gait and complex stereotyped movements of the hands after a complicated repair of an aortic coarctation. An MRI scan showed a right putaminal infarct. The boy's behavior and stereotypies bear a close resemblance to those found in autism.
Insights
A 17-year-old boy developed circling and hand stereotypies after aortic coarctation repair. An MRI revealed a putaminal infarct, suggesting a link between the injury and the observed neurological symptoms.
Area of Science:
- Neurology
- Cardiology
- Developmental Pediatrics
Background:
- Aortic coarctation repair is a complex cardiovascular procedure.
- Neurological complications can arise following cardiac surgery, particularly in pediatric patients.
- Stereotyped movements and gait disturbances are significant neurological signs.
Observation:
- A 17-year-old male presented with new-onset circling behavior affecting his gait.
- Complex, stereotyped hand movements were also observed postoperatively.
- These symptoms emerged after a complicated surgical repair of aortic coarctation.
Findings:
- Magnetic Resonance Imaging (MRI) revealed an infarct in the right putamen.
- The putaminal infarct is a potential cause of the observed motor and behavioral changes.
- The patient's behavioral phenotype showed similarities to autistic traits.
Implications:
- This case highlights a potential association between putaminal injury and specific neurological deficits after aortic coarctation repair.
- Understanding these associations is crucial for managing pediatric patients with congenital heart disease.
- Further research may elucidate the specific pathways linking putaminal damage to behavioral changes resembling autism.