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Document Type

Original Article

Abstract

OBJECTIVE:
To determine the frequency of cerebrovascular accidents and brain abscess in children of Tetralogy of Fallot presented with neurological manifestations.

PATIENTS AND METHODS:
It was a cross-sectional descriptive observational study done at the Pediatric Cardiology and Pediatric Neurology departments of The Children’s Hospital & Institute of Child Health, Lahore from Dec 2009 to Nov 2010. A total 75 patients of Tetralogy of Fallot (TOF) up to the age of 15 years with neurological manifestation meeting the inclusion criteria were enrolled in this study. CT brain with contrast was conducted in all patients to look for evidence of cerebrovascular accident (stroke) and/or brain abscess.

RESULTS:
Out of total 75 patients of Tetralogy of Fallot (TOF) presented with neurological manifestation 48 (64%) were having brain abscess, 24 (32%) were having cerebrovascular accident (CVA), 2 (2.6%) were having intracranial bleed and 1 (1.3%) was having meningoencephlitis. Disease breakdown according to age showed increasing frequency of brain abscess as age increases with maximum cases above 10 years of age. However maximum cases of CVA reported in patients below age of 2years.

CONCLUSION:
Brain abscess have found to be more frequent than cerebrovascular accidents in patients with tetralogy of fallot. Therefore, we should have a high index of suspicion of brain abscess in every unoperated patient of tetralogy of fallot presenting with neurological manifestation.

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