Neurological complications of heart disease in childhood

A retrospective review was undertaken of 10 years experience in a Regional referral centre for cardiothoracic surgery identified 37 children with cardiovascular disease who developed chronic neurological handicap. In two-thirds of these, neurological lesions occurred in association with cardiovascular surgery, whilst in one-third they were unrelated to surgery. Motor handicap was found in the majority (94 per cent) of cases, with hemiplegia, tetraplegia and paraplegia being the most common patterns. In half the children, motor and intellectual function was severely impaired. Neurological complications of cardiovascular disease account for approximately two per cent of children with cerebral palsy in the area served by our hospital. One per cent of children undergoing cardiopulmonary bypass surgery risk chronic neurological handicap. Potentially avoidable factors could only be identified in a small proportion of cases.