Journal article
Neuroimaging of Neonatal Stroke: Venous Focus
Radiographics, Vol.44(2), e230117
02/2024
DOI: 10.1148/rg.230117
PMID: 38206831
Abstract
Perinatal venous infarcts are underrecognized clinically and at imaging. Neonates may be susceptible to venous infarcts because of hypercoagulable state, compressibility of the dural sinuses and superficial veins due to patent sutures, immature cerebral venous drainage pathways, and drastic physiologic changes of the brain circulation in the perinatal period. About 43% of cases of pediatric cerebral sinovenous thrombosis occur in the neonatal period. Venous infarcts can be recognized by ischemia or hemorrhage that does not respect an arterial territory. Knowledge of venous drainage pathways and territories can help radiologists recognize characteristic venous infarct patterns. Intraventricular hemorrhage in a term neonate with thalamocaudate hemorrhage should raise concern for internal cerebral vein thrombosis. A striato-hippocampal pattern of hemorrhage indicates basal vein of Rosenthal thrombosis. Choroid plexus hemorrhage may be due to obstruction of choroidal veins that drain the internal cerebral vein or basal vein of Rosenthal. Fan-shaped deep medullary venous congestion or thrombosis is due to impaired venous drainage into the subependymal veins, most commonly caused by germinal matrix hemorrhage in the premature infant and impeded flow in the deep venous system in the term infant. Subpial hemorrhage, an underrecognized hemorrhage stroke type, is often observed in the superficial temporal region, and its cause is probably multifactorial. The treatment of cerebral sinovenous thrombosis is anticoagulation, which should be considered even in the presence of intracranial hemorrhage.
RSNA, 2024 Test Your Knowledge questions in the supplemental material and the slide presentation from the RSNA Annual Meeting are available for this article.
Details
- Title: Subtitle
- Neuroimaging of Neonatal Stroke: Venous Focus
- Creators
- Lillian M Lai - University of IowaTakashi Shawn Sato - From the Department of Radiology, University of Iowa Stead Family Children's Hospital, 200 Hawkins Dr, Iowa City, IA 52242-1077Sedat Giray Kandemirli - From the Department of Radiology, University of Iowa Stead Family Children's Hospital, 200 Hawkins Dr, Iowa City, IA 52242-1077Natally AlArab - From the Department of Radiology, University of Iowa Stead Family Children's Hospital, 200 Hawkins Dr, Iowa City, IA 52242-1077Yutaka Sato - From the Department of Radiology, University of Iowa Stead Family Children's Hospital, 200 Hawkins Dr, Iowa City, IA 52242-1077
- Resource Type
- Journal article
- Publication Details
- Radiographics, Vol.44(2), e230117
- DOI
- 10.1148/rg.230117
- PMID
- 38206831
- eISSN
- 1527-1323
- Grant note
- name: Edmund A. Franken, Jr., Professor in Pediatric Radiology fund
- Language
- English
- Date published
- 02/2024
- Academic Unit
- Radiology; Stead Family Department of Pediatrics
- Record Identifier
- 9984543459902771
Metrics
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