@article {Kellyarchdischild-2018-314822, author = {Christopher J Kelly and Sophie Arulkumaran and Catarina Trist{\~a}o Pereira and Lucilio Cordero-Grande and Emer J Hughes and Rui Pedro A G Teixeira and Johannes K Steinweg and Suresh Victor and Kuberan Pushparajah and Joseph V Hajnal and John Simpson and A David Edwards and Mary A Rutherford and Serena J Counsell}, title = {Neuroimaging findings in newborns with congenital heart disease prior to surgery: an observational study}, elocation-id = {archdischild-2018-314822}, year = {2019}, doi = {10.1136/archdischild-2018-314822}, publisher = {BMJ Publishing Group Ltd}, abstract = {Objectives Neurodevelopmental impairment has become the most important comorbidity in infants with congenital heart disease (CHD). We aimed to (1) investigate the burden of brain lesions in infants with CHD prior to surgery and (2) explore clinical factors associated with injury.Study design Prospective observational study.Setting Single centre UK tertiary neonatal intensive care unit.Patients 70 newborn infants with critical or serious CHD underwent brain MRI prior to surgery.Main outcome measures Prevalence of cerebral injury including arterial ischaemic strokes (AIS), white matter injury (WMI) and intracranial haemorrhage.Results Brain lesions were observed in 39\% of subjects (95\% CI 28\% to 50\%). WMI was identified in 33\% (95\% CI 23\% to 45\%), subdural haemorrhage without mass effect in 33\% (95\% CI 23\% to 45\%), cerebellar haemorrhage in 9\% (95\% CI 4\% to 18\%) and AIS in 4\% (95\% CI 1.5\% to 12\%). WMI was distributed widely throughout the brain, particularly involving the frontal white matter, optic radiations and corona radiata. WMI exhibited restricted diffusion in 48\% of cases. AIS was only observed in infants with transposition of the great arteries (TGA) who had previously undergone balloon atrial septostomy (BAS). AIS was identified in 23\% (95\% CI 8\% to 50\%) of infants with TGA who underwent BAS, compared with 0\% (95\% CI 0\% to 20\%) who did not.Conclusions Cerebral injury in newborns with CHD prior to surgery is common.}, issn = {0003-9888}, URL = {https://adc.bmj.com/content/early/2019/07/05/archdischild-2018-314822}, eprint = {https://adc.bmj.com/content/early/2019/07/05/archdischild-2018-314822.full.pdf}, journal = {Archives of Disease in Childhood} }