Gómez, Manuel R.

Two cases of severe neurologic symptoms after a Blalock-Taussig anastomosis are presented in detail. The histories of 116 patients with cyanotic congenital heart disease who had such an anastomotic operation at the Mayo Clinic were reviewed. There was a low incidence (less than 1%) of postoperative neurologic complications in patients without evidence of focal dysfunction of the central nervous system prior to operation. The review suggested an increased incidence of complications in those patients with a cerebrovascular abnormality before surgery. It is likely that these complications are related to alterations in the vertebrobasilar arterial system associated with this procedure.

AbstractCT and MR have permitted radiology to play a greater, but not definitive, role in detecting the pathologic components of tuberous sclerosis. SEN may be identified in only 80% of patients. Tubers are more ubiquitous and readily identified by MR in children and adults when the brain is myelinated. Since tubers are predominately peripheral hypomyelinated lesions, the detection of small lesions may be delayed until an infant is over 16–18 months of age when the myelin will have extended to the junction between the cortical white and gray matter. SEGA typically evolve later during the first and second decades of life. Successful genetic counseling implies a need to detect tuberous sclerosis at a stage during infancy when imaging may fail to confirm the diagnosis, so tuberous sclerosis remains a clinical diagnosis.