Selective injury of the globus pallidus in children with post-cardiac surgery choreic syndrome

Dev Med Child Neurol. 1995 Feb;37(2):135-44. doi: 10.1111/j.1469-8749.1995.tb11983.x.


Occasionally children undergoing cardiac surgery using cardiopulmonary bypass with deep hypothermia and cardiac arrest develop a postoperative syndrome of acute chorea. The authors report the neuropathological findings in two such children surgically treated for congenital heart disease. Examination of the brain showed neuronal loss, reactive astrocytosis and degeneration of myelinated fibers (without frank necrosis) in the globus pallidus, primarily the outer segment, with sparing of other regions commonly susceptible to hypoxic-ischemic necrosis. The localization and relative mildness of the brain damage suggest a susceptibility of the globus pallidus to injury in this setting and implicate disruption of pallidal pathways in the pathogenesis of post-cardiac surgery choreic syndrome.

Publication types

  • Case Reports

MeSH terms

  • Acute Disease
  • Athetosis / etiology*
  • Athetosis / pathology
  • Brain Ischemia / etiology*
  • Brain Ischemia / pathology
  • Cardiopulmonary Bypass / adverse effects*
  • Child, Preschool
  • Chorea / etiology*
  • Chorea / pathology
  • Fatal Outcome
  • Female
  • Globus Pallidus / blood supply*
  • Globus Pallidus / pathology
  • Heart Defects, Congenital / surgery*
  • Humans
  • Infant
  • Male
  • Syndrome