#456 - [Journal Club] - 🫀 From The Heart - Should an Abnormal Brain MRI Change the Decision to Operate in Critical CHD?

In this systematic review and meta-analysis, Nim and Adrianne dig into just how common brain injury really is in neonates with critical congenital heart disease. Pooling 31 studies spanning two decades, the authors found that nearly 70% of these babies show some form of ischemic brain injury, split roughly between pre-operative and post-operative timing. Counter to what most clinicians would predict, kids who went to surgery earlier (days 4-6) had higher rates of white matter injury than those who waited longer. MRI remained the most sensitive tool for picking up these lesions, well ahead of ultrasound or CT. But the data stops well short of proving these findings predict long-term outcomes, and Nim pushes back on the idea that an abnormal scan alone should steer decisions about whether to operate. \---- Prevalence of Ischemic Brain Injury in Neonates With Congenital Heart Disease: A Systematic Review and Meta-Analysis. Kim C, Chetan D, Kazazian V, Alzamil J, Chau V, Seed M, Miller SP, Selvanathan T.Neurology. 2026 Feb 10;106(3):e214569. doi: 10.1212/WNL.0000000000214569. Epub 2026 Jan 9.PMID: 41512205 Support the show As always, feel free to send us questions, comments, or suggestions to our email: nicupodcast@gmail.com. You can also contact the show through Instagram or Twitter, @nicupodcast. Or contact Ben and Daphna directly via their Twitter profiles: @drnicu and @doctordaphnamd. The papers discussed in today's episode are listed and timestamped on the webpage linked below. Enjoy!