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Neonatal cerebral thrombosis

Laura Merlini, Sylviane Hanquinet, Joel Fluss
BACKGROUND: Neonatal thalamic hemorrhagic stroke is related to cerebral sinus venous thrombosis and associated with neurological sequelae. Predicting factors are however lacking. METHODS: Clinical and radiological findings at onset and on follow-up of 5 neonates with thalamic hemorrhage stroke are described. RESULTS: All neonates presented with abrupt lethargy, ophistotonos, irritability and/or seizures. The thalamic hemorrhagic stroke was most often unilateral (4/5), involving the posterior/entire thalamus in 3 cases and the anterior thalamus in 2...
January 1, 2017: Journal of Child Neurology
Jamie O Lo, Victoria H J Roberts, Matthias C Schabel, Xiaojie Wang, Terry K Morgan, Zheng Liu, Colin Studholme, Christopher D Kroenke, Antonio E Frias
The placenta is a vital organ necessary for healthy fetal development. Placental insufficiency creates an in utero environment where the fetus is at risk of insufficient oxygen or nutrient exchange. This is primarily caused by impairment of either maternal or fetal circulation or vascular thrombosis such as placental infarction. As a result of placental dysfunction, affected fetuses may be growth restricted, neurologically impaired, and at risk of increased morbidity and mortality. In a cohort of 4 pregnant Rhesus macaques, we describe antenatal detection of naturally occurring intrauterine growth restriction (IUGR) and aberrant fetal neurodevelopment in 1 animal...
January 1, 2017: Reproductive Sciences
Sarah Lee, David M Mirsky, Lauren A Beslow, Catherine Amlie-Lefond, Amy R Danehy, Laura Lehman, Nicholas V Stence, Arastoo Vossough, Max Wintermark, Michael J Rivkin
PURPOSE: To provide consensus-based, suggested imaging protocols to facilitate the accurate and timely diagnosis of a neonate with symptoms concerning for stroke. METHODS: The Writing Group, an international collaboration of pediatric neurologists and neuroradiologists with expertise in perinatal and childhood stroke, participated in a series of pediatric stroke neuroimaging symposia. These discussions, in conjunction with extensive literature review, led to a consensus for imaging protocols to guide practitioners in the diagnosis of neonatal stroke subtypes as defined by the National Institute of Neurological Disorders and Stroke Common Data Elements...
January 26, 2017: Pediatric Neurology
Lauran Cole, Deborah Dewey, Nicole Letourneau, Bonnie J Kaplan, Kathleen Chaput, Clare Gallagher, Jacquie Hodge, Amalia Floer, Adam Kirton
Importance: Hemorrhage into the brain of term newborns often results in major injury and lifelong disability. The clinical epidemiology of neonatal hemorrhagic stroke (NHS) remains undefined, hindering the development of strategies to improve outcomes. Objective: To characterize the incidence, types, presentations, associated factors, and outcomes of neonatal hemorrhagic stroke. Design, Setting, and Participants: Population-based, nested case-control study...
March 1, 2017: JAMA Pediatrics
Nongnuch Sirachainan, Anchalee Limrungsikul, Ampaiwan Chuansumrit, Pracha Nuntnarumit, Lunliya Thampratankul, Somporn Wangruangsathit, Werasak Sasanakul, Praguywan Kadegasem
BACKGROUND: The incidences of thromboembolism (TE) in neonates were reported to be around 0.51 per 10,000 live births per year for overall TE and 24 per 10,000 NICU admissions per year. As the incidences of TE in children and adults are lower in Asian populations, the incidences, risk factors, and outcomes of neonatal TE may be different to those reports from other countries. OBJECTIVES: To determine the incidences, risk factors, and outcomes of neonatal TE in a tertiary care hospital in Thailand...
February 9, 2017: Journal of Maternal-fetal & Neonatal Medicine
Toshiaki Taoka, Akio Fukusumi, Toshiteru Miyasaka, Hisashi Kawai, Toshiki Nakane, Kimihiko Kichikawa, Shinji Naganawa
Deep medullary veins drain into subependymal veins with four convergence zones and show parallel distribution patterns adjacent to the body or inferior horn and a radial pattern in the frontal horn or trigon of the lateral ventricle. As white matter imaging develops such as diffusion tensor imaging or susceptibility-weighted imaging, requirements for understanding of white matter structures are increasing, not only for understanding of neuronal tracts but also for that of other structures including the fine anatomy of white matter vessels...
January 2017: Radiographics: a Review Publication of the Radiological Society of North America, Inc
Maurizio Radicioni, Vittorio Bini, Pietro Chiarini, Ambra Fantauzzi, Francesca Leone, Raffaella Scattoni, Pier Giorgio Camerini
BACKGROUND: Cerebral sinovenous thrombosis is unusual in the asphyxiated cooled infants, but reliable data regarding the incidence of this comorbidity are lacking. We assessed the incidence of sinovenous thrombosis in a population of asphyxiated cooled infants by performing routine brain magnetic resonance venography. METHODS: All asphyxiated infants who underwent therapeutic cooling at our institution completed brain magnetic resonance venography after rewarming...
January 2017: Pediatric Neurology
Marlene Biermayr, Barbara Brunner, Kathrin Maurer, Rudolf Trawoeger, Ursula Kiechl-Kohlendorfer, Vera Neubauer
BACKGROUND: Thrombosis in neonates is commonly a central venous access device (CVAD) associated complication. Furthermore, a patent foramen ovale (PFO) is frequently seen in preterm infants. Even though a coincidence of both is not unusual, detaching of the thrombus and organisation of an aortic embolism has not been described until now. Treatment recommendations of CVAD-associated thrombosis in neonates do not consider frequently seen complications of preterm infants e.g. intraventricular haemorrhage...
2016: BMC Pediatrics
Alexander Drofa, Evgueni Kouznetsov, Stephen Tomek, Matthew Wiisanen, Michael Manchak, Timothy Lindley, Steven Mitchell, Ferdinand Hui, Dane Breker
Cerebral sinus venous thrombosis (CSVT) is a recognized cause of childhood and neonatal stroke. More than 50% of neonates have a poor outcome, and mortality is high. Coma is a predictor of death in neonatal CSVT. We present the case of a 9-day-old infant, who presented in coma and was treated successfully with a combination of mechanical thrombectomy using the MindFrame System via the right jugular vein, local infusion of recombinant tissue plasminogen activator and abciximab, as well as anticoagulation. In this case, aggressive thrombectomy and thrombolysis achieved complete neurologic restoration safely and quickly...
2016: Pediatric Neurosurgery
Melissa G Chung
Investigators from Erasmus University Hospital in Belgium and Gustave-Dron Hospital and Roger-Salengro Hospital in France studied the clinical and neuroradiologic characteristics of cerebral sinovenous thrombosis (CSVT) in neonates and children.
March 2016: Pediatric neurology briefs
Pinar Altiaylik Ozer, Emrah Utku Kabatas, Bengi Ece Kurtul, Dilek Dilli, Aysegul Zenciroglu, Nurullah Okumus
Neonatal hypernatremia is an important electrolyte disorder that may have serious complications. It may be a rare and underdiagnosed cause of venous and arterial thrombosis, leading to severe brain damage by cerebral edema and intracranial hemorrhage. Here, the authors present a case of bilateral central retinal artery occlusion in a newborn with severe hypernatremic dehydration who is found to be normal in terms of other causes of retinal arterial thromboembolization. [Ophthalmic Surg Lasers Imaging Retina...
May 1, 2016: Ophthalmic Surgery, Lasers & Imaging Retina
Kenichi Tetsuhara, Akira Ishiguro, Nobuaki Michihata, Sonoko Sensaki, Hisaya Nakadate, Yui Kimura, Daisuke Tomizawa, Kimikazu Matsumoto
OBJECTIVES: To investigate the clinical and epidemiologic characteristics of thromboembolism in Japanese children. METHODS: Clinical data of 77 patients with thromboembolism from a national tertiary pediatric care center were reviewed. RESULTS: Incidence of thromboembolism was calculated to be 15 per 10,000 hospital admissions. Infants younger than one year of age made up the largest age group (25 patients, including nine neonates younger than 30 d)...
October 2016: Indian Journal of Pediatrics
Chiara Carducci, Giovanna Stefania Colafati, Lorenzo Figà-Talamanca, Daniela Longo, Tommaso Lunardi, Francesco Randisi, Bruno Bernardi
Cerebral sinovenous thrombosis (CSVT) is a relatively uncommon and potentially life-threatening condition in childhood, occurring in various clinical settings. Nowadays, however, it is increasingly diagnosed as related to many causes, likely due to greater clinical awareness and improvement of neuroradiologic techniques. The prompt diagnosis is an important goal to significantly reduce the risk of acute complications and long-term sequelae. The purpose of this narrative overview is to provide a useful educational tool in daily clinical practice for radiologists with a broad perspective of CSVT including a discussion of more common potential pitfalls related to misinterpretation of images in children...
May 2016: La Radiologia Medica
Matsanga Leyila Kaseka, Mahendranath Moharir, Gabrielle deVeber, Daune MacGregor, Rand Askalan, Nomazulu Dlamini
BACKGROUND: Descending corticospinal tract diffusion-weighted magnetic resonance imaging (MRI) signal is predictive of poor motor outcome in neonatal and childhood arterial ischemic stroke. However, descending corticospinal tract diffusion-weighted MRI signal has not been documented in the setting of cerebral sinovenous thrombosis, and its role is not understood. OBJECTIVE: We describe a neonate with cerebral sinovenous thrombosis, extensive diffusion restriction, and bilateral descending corticospinal tract diffusion-weighted MRI signal on MRI of the brain...
June 2016: Pediatric Neurology
Valentina Lolli, Francesco Molinari, Jean-Pierre Pruvo, Gustavo Soto Ares
BACKGROUND AND PURPOSE: Cerebral sinovenous thrombosis (CSVT) represents an increasingly recognized cause of pediatric stroke. Our purpose was to assess gender and age differences in the etiology, clinical presentation, and imaging features of CSVT in neonates and older children. METHODS: Subjects aged newborn to 18 years diagnosed with CSVT at the Lille university hospital between 2011 and 2014 were included. RESULTS: Eleven neonates and 16 non-neonates constituted the study population...
July 2016: Journal of Neuroradiology. Journal de Neuroradiologie
Sarah H O'Brien
Stroke is more likely to occur in the perinatal period than any other time in childhood, and these events can lead to a lifetime of intellectual and motor disabilities, epilepsy, and behavioral challenges. This review describes the epidemiology and natural history of perinatal arterial ischemic stroke (PAIS) and cerebral sinovenous thrombosis (CSVT), risk factors for these complications, recent evidence regarding treatment strategies, and current gaps in knowledge. Existing evidence demonstrates the multifactorial etiology of symptomatic ischemic stroke in neonates, which includes a combination of maternal, delivery, and neonatal factors...
2015: Hematology—the Education Program of the American Society of Hematology
Sadık Yurttutan, Mehmet Yekta Oncel, Nursel Yurttutan, Halil Degirmencioglu, Nurdan Uras, Ugur Dilmen
Lethargy in newborns usually indicates central nervous system dysfunction, and many conditions such as cerebrovascular events, infections, and metabolic diseases should be considered in the differential diagnosis. Nonketotic hyperglycinemia is an autosomal recessive error of glycine metabolism, characterized by myoclonic jerks, hypotonia, hiccups, apnea, and progressive lethargy that may progress to encephalopathy or even death. Cerebral sinovenous thrombosis is a rare condition with various clinical presentations such as seizures, cerebral edema, lethargy, and encephalopathy...
June 2015: Korean Journal of Pediatrics
Mesut Yenigün, Martin Jünemann, Tibo Gerriets, Erwin Stolz
Cerebral venous sinus thrombosis (CVST) is an important cause of stroke in young patients. CVST represents with 0.5-3% of stroke cases a relatively rare disease. CVST affects 3-4 cases per 1 million overall and 7 cases per 1 million children and neonates. Typical clinical symptoms include headache, visual deficits and seizures. Beside the main condition associated with CVST in women in pregnancy and puerperium, the most frequently identified risk factors are oral hormonal contraceptives in combination with coagulation disorders...
June 2015: Annals of Translational Medicine
Virgínia Machado, Sónia Pimentel, Filomena Pinto, José Nona
OBJECTIVE: To study the incidence, clinical presentation, risk factors, imaging diagnosis, and clinical outcome of perinatal stroke. METHODS: Data was retrospectively collected from full-term newborns admitted to the neonatal unit of a level III maternity in Lisbon with cerebral stroke, from January 2007 to December 2011. RESULTS: There were 11 cases of stroke: nine were arterial ischemic stroke and two were cerebral venous sinus thrombosis...
January 2015: Einstein
Agnese Suppiej, Chiara Gentilomo, Paola Saracco, Stefano Sartori, Manuela Agostini, Rossana Bagna, Bianca Bassi, Paola Giordano, Massimo Grassi, Andrea Guzzetta, Donatella Lasagni, Matteo Luciani, Angelo C Molinari, Antonella Palmieri, Maria Caterina Putti, Luca Antonelli Ramenghi, Lidia Luciana Rota, Domenico Sperlì, Anna Maria Laverda, Paolo Simioni
Data from large case series of children with cerebral thrombotic events are pivotal to improve prevention, early recognition and treatment of these conditions. The Italian Registry of Pediatric Thrombosis (R. I. T. I.) was established in 2007 by a multidisciplinary team, aiming for a better understanding of neonatal and paediatric thrombotic events in Italy and providing a preliminary source of data for the future development of specific clinical trials and diagnostic-therapeutic protocols. We analysed data relative to the paediatric cerebral thrombotic events of the R...
June 2015: Thrombosis and Haemostasis
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