[Central nervous system complications in patients with cyanotic congenital heart diseases (author's transl)]

The Author studies neurologic complications and neuro-psychic development in children with cyanotic congenital heart diseases about his experience and the data of the literature. Central nervous system complications in cyanotic children are of two types: cerebrovascular accidents and brain abcess. Cerebrovascular accidents are more frequent before 4 years of age; they are acute and unexpected. Anoxia and hypochromia are the most important factors with acidosis and hemoconcentration. In children after 4 years of age chronic hypoxia and high level of hematocrit are of concern, sometimes with coagulation disturbances. The mortality rate is 10 to 15 per cent. Brain abcess is rare before 3 years of age, the main age is between 8 and 10. The factors are: chronic brains lesions, bacteriemia without pulmonic filter by right to left shunt. The mortality rate is 25 to 33 per cent. The treatment is essentially neuro-surgical, with often severe sequellae. Many factors influence neurologic and intellectual development in cyanotic children, including chronic brain hypoxia, physical limitation, familial habits. For all types of neuropsychic damages early corrective surgery seems to be the best preventing treatment.