Cerebrovascular accidents in neonates treated with extracorporeal membrane oxygenation: sonographic-pathologic correlation

Taylor, George A.; Fitz, Charles R.; Kapur, Subhash C; Short, Billie Lou

doi:10.2214/ajr.153.2.355

Cited by 27 publications

(4 citation statements)

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“…Although prematurity may be the most common cause for cerebellar hemorrhage, other causes have been indicated including Extracorporeal membrane oxygenation (ECMO), birth trauma, and nonimmune hydrops fetalis . During the period of this study, we diagnosed a posterior fossa hemorrhage in one term infant with premature rupture of membranes (PROM), convulsions, and grade 4 cerebral hemorrhages.…”

Section: Discussionmentioning

confidence: 99%

“…[10][11][12][13] Although prematurity may be the most common cause for cerebellar hemorrhage, other causes have been indicated including Extracorporeal membrane oxygenation (ECMO), birth trauma, and nonimmune hydrops fetalis. [37][38][39][40] During the period of this study, we diagnosed a posterior fossa hemorrhage in one term infant with premature rupture of membranes (PROM), convulsions, and grade 4 cerebral hemorrhages. Posterolateral US scans are also valuable to detect cerebellar leukomalacia, vermian anomalies, Chiari malformations, arteriovenous malformations, arachnoid cyst, mega cisterna magna, fungal abscesses, and dural vein thrombosis.…”

Section: Discussionmentioning

confidence: 99%

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Cerebellar hemorrhage in very low birth weight premature infants: The advantage of the posterolateral fontanelle view

Soudack

Jacobson

Raviv-Zilka

et al. 2013

J of Clinical Ultrasound

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cerebellar hemorrhage in very low birth weight premature infants: The advantage of the posterolateral fontanelle view

Soudack

Jacobson

Raviv-Zilka

et al. 2013

J of Clinical Ultrasound

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“…Other uses of the foramen magnum window also may be possible, particularly in patients treated with ECMO, who are at increased risk for cerebellar hemorrhage. [12][13][14][15][16] In these patients, restrictive supine positioning excludes the use of the posterior fontanelle as an acoustic window. Gently turning the infant's head to the side that has been cannulated allows access to scan the posterior fossa using the foramen magnum window and technique described herein.…”

Section: Discussionmentioning

confidence: 99%

The foramen magnum: the underutilized acoustic window to the posterior fossa

Sudakoff¹,

Montazemi²,

Rifkin³

1993

Journal of Ultrasound in Medicine

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Visualization of the posterior fossa during neonatal cranial sonography through the anterior fontanelle can at times be limited. To improve visualization of the posterior fossa, the foramen magnum was used as an acoustic window. Scans through the foramen magnum were obtained in addition to routine scans via the anterior fontanelle in 21 preterm infants. A subjective and retrospective evaluation was performed comparing clarity and definition of posterior fossa structures using the anterior fontanelle and foramen magnum. Images of the fourth ventricle, pons, vermis, cerebellar hemispheres, and cistema magna were considered superior in clarity and definition when obtained via the foramen magnum. The tentorium was visualized equally well with both windows. Foramen magnum scanning demonstrated improved clarity of two Dandy-Walker variants in comparison to anterior fontanelle scanning. The use of the foramen magnum in addition to other acoustic windows can improve perceived clarity and definition of posterior fossa structures and aid in the detection of abnormalities and anomalies occurring in this location. KEY WORDS: Foramen magnum; Posterior fossa; Ultrasound.can be used to better visualize these structures.' However, these additional windows often are variable in size, limiting their field of view or inaccessible due to overlying intravenous lines and their protective coverings. Furthermore, restrictive supine positioning in infants treated with extracorporeal membrane oxygenation (ECMO) often excludes the use of posterior fontanelle as an acoustic window. Because of its size and location, the foramen magnum is usually not affected by accessibility or patient positioning, which can affect other cranial windows. In an attempt to evaluate the use of foramen magnum acoustic window we compared this view to conventional anterior fontanelle coronal images. This report demonstrates the approach and application of this technique. MATERIALS AND METHODSTwenty-one preterm infants underwent routine cranial sonography via the anterior fontanelle and foramen magnum. Examinations were always performed

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“…The flow abnormalities caused by the extensive tubing in ECMO and the lining of the tubing itself may lead to activation of platelets and the coagulation cascade with resultant clots in the circuit and subsequent embolization. 74 ECMO has been associated with both AIS 75,76 and SVT 71,77 in neonates, and some neonates on ECMO may have underlying prothrombotic disorders which raise the complication rate. 78…”

Section: Extracorporeal Membrane Oxygenationmentioning

confidence: 99%

The Contribution of Prothrombotic Disorders to Peri- and Neonatal Ischemic Stroke

2003

Semin Thromb Hemost

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Prothrombotic disorders are believed to be important contributors to the etiology of peri- and neonatal arterial ischemic stroke and sinovenous thrombosis, which may lead to life-long disability. This article reviews hematological issues unique to the perinatal period, including: the significance of the placenta as the interface between maternal and fetal circulations; normal changes in the coagulation system of mothers during and just after gestation; and the significance of prothrombotic disorders in the mother and/or fetus. Other possible maternal and neonatal contributors to peri- and neonatal stroke are discussed, including: infection, pre-eclampsia, diabetes, and drug use in the mother; and infection, dehydration, complex congenital heart disease, extracorporeal membrane oxygenation, and catheter placement in the neonate. Possible approaches to preventing and treating perinatal and neonatal stroke are presented.

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Cerebrovascular accidents in neonates treated with extracorporeal membrane oxygenation: sonographic-pathologic correlation

Cited by 27 publications

References 0 publications

Cerebellar hemorrhage in very low birth weight premature infants: The advantage of the posterolateral fontanelle view

Cerebellar hemorrhage in very low birth weight premature infants: The advantage of the posterolateral fontanelle view

The foramen magnum: the underutilized acoustic window to the posterior fossa

The Contribution of Prothrombotic Disorders to Peri- and Neonatal Ischemic Stroke

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