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Brain degeneration
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Brain degeneration


  Ten hours after my son's birth he was placed on ECMO, due to a congenital diaphragmatic hernia.
  He remained on it for ten days and upon decannulation, an ultrasound showed a normal brain. His lungs continued to
  improve for the next five weeks. When he was six weeks old he went to the OR for a fundoplication and gtube placement.
  Twelve hours post-op, he went into cardiac arrest, requiring ten minutes of CPR and two epi's.
  In the next week, after he began to wake up more, I noticed that he had a left gaze preference, and was arching.
  An MRI and CT a week later revealed that he had suffered a significant left middle cerebral artery infarct. It has not
  been determined when the infarct occurred, whether it was on ECMO or during the arrest. Does an infant's brain degenerate
  at the same rate as an adult's? Is it possible to determine when the infarct occurred? And what kind of specialist can
  evaluate this? A pediatric radiologist/neurologist...?
  Please respond....my peace of mind is at stake.
_____________________
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Dear Megan,
It will be difficult to determine exactly when the infarct occurred in your
child.  One may gain clues from the CT or from the child's neurological status
during these times, but even then it will be difficult.  
Fortunately a child has a good prognosis neurologically from the infarct.  
In an adult, a left middle cerebral infarct would leave the patient unable
to speak and unable to move the right side.  Interestingly, children, until
approximately age 7, are still developing their brain circuitry and are able
to 'rewire' some functions to other areas after an insult such as this.  
This is what is called the 'plasticity' of youth.  
A consult to a pediatric neurologist would be wise in your situation
to clarify some issues.  At the least it would grant you some peace of mind.
Good luck.







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