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November 1990

Transient Changes in Neuroimaging Appearances of the Brain Following Cardiopulmonary Bypass-Reply

Author Affiliations

Departments of Radiology and Pediatrics
Department of Radiology
Department of Pediatrics University of Nebraska Medical Center 600 S 42nd St Omaha, NE 68198

Am J Dis Child. 1990;144(11):1184. doi:10.1001/archpedi.1990.02150350014013

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In Reply.—We would like to thank Drs Welch and Byrne for their comments. We agree that the true incidence of persistent cerebral changes after cardiopulmonary bypass may be lower than our report suggests. Nevertheless, ventriculomegaly and dilatation of the subarachnoid spaces must remain a concern as we continue to operate on smaller and smaller children with increasingly complex lesions. Although these seem to be transient findings, as pediatricians we are frequently reminded of the subtle changes that occur in children's behavior and performance in much later stages of their lives. Additionally, we are concerned that prolonged cardiopulmonary bypass with the attendant problems with cerebral water may seem transient but may have more prolonged effects. Certainly, we cannot exclude the alternative possibility or perhaps the additional possibility that there is transient intracranial venous hypertension.

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