Autopsy study of cerebral complications of congenital heart disease and cardiac surgery.

Detailed histological investigation of the brains of 45 neonates, infants and children who had died of various congenital heart defects revealed that the damage to the white matter occurred mostly below 3 months of age, while that to the grey matter occurred above this age. The lesions (glial fatty metamorphosis, telencephalic leucoencephalopathy, focal white matter necrosis, focal nerve cell pyknosis and symmetrical cortical necrosis) were often combined with each other. The necroses were generally not a consequence of microembolization. Various cerebral complications occurred in most of the patients who had undergone cardiac surgery. However, the various cerebral lesions each had several causes and in general the accumulation of predisposing damaging noxae resulted in more serious changes.