PT - JOURNAL ARTICLE AU - Christopher J Kelly AU - Sophie Arulkumaran AU - Catarina Tristão Pereira AU - Lucilio Cordero-Grande AU - Emer J Hughes AU - Rui Pedro A G Teixeira AU - Johannes K Steinweg AU - Suresh Victor AU - Kuberan Pushparajah AU - Joseph V Hajnal AU - John Simpson AU - A David Edwards AU - Mary A Rutherford AU - Serena J Counsell TI - Neuroimaging findings in newborns with congenital heart disease prior to surgery: an observational study AID - 10.1136/archdischild-2018-314822 DP - 2019 Nov 01 TA - Archives of Disease in Childhood PG - 1042--1048 VI - 104 IP - 11 4099 - http://adc.bmj.com/content/104/11/1042.short 4100 - http://adc.bmj.com/content/104/11/1042.full SO - Arch Dis Child2019 Nov 01; 104 AB - 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.