Importance of hypoxic/ischemic conditions in the development of cerebral lenticulostriate vasculopathy

Coley, Brian D.; Rusin, Jerome; Boué, Daniel R.

doi:10.1007/s002470000322

Cited by 50 publications

(65 citation statements)

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“…Extending the recent observation of El Ayoubi et al 12 (28 of 70 neonates with LSV had either intraventricular hemorrhage (IVH) or periventricular leucomalacia (PVL), in this study, through the use of multivariate logistic regression, the reader will find we have confirmed that a statistically significant and unconfounded relationship exists between neonatal IVH and LSV, the latter being a lesion that we, as did Hemachandra et al 11 and Coley et al, 10 have found to be more common than reported in the older medical literature.…”

Section: Introductionsupporting

confidence: 79%

“…However, it may be that the growing awareness of its presence and the advent of more sophisticated cranial imaging devices with improved resolution may account for some, if not all, of the reported increase in LSV prevalence. For example, in 2000, Coley et al 10 reported that more than 4.2% of neonates in their study were found to have the lesion. More recently, Hemachandra et al, 11 in a retrospective study published in this Journal, also found that LSV was not uncommon (prevalence of 4.6% (21 of 453 reviewed cranial images)).…”

Section: Introductionmentioning

confidence: 95%

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Association between Lenticulostriate Vasculopathy (LSV) and Neonatal Intraventricular Hemorrhage (IVH)

et al. 2004

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OBJECTIVES:To determine whether there is an unconfounded association between neonatal intraventricular hemorrhage (IVH) and lenticulostriate vasculopathy (LSV (also known as thalamostriate or mineralizing vasculopathy)). STUDY DESIGN:During the conduct of the Magnesium and Neurologic Endpoints Trial (MagNET), a randomized controlled trial involving maternal, hence fetal, exposure to antenatal magnesium sulfate in the context of preterm labor, head ultrasounds were obtained for each of the surviving neonates. Because of our previous experience in the diagnosis of LSV, when ascertaining the presence of IVH, as called for by the research protocol of our study, the presence or absence of LSV was also determined. RESULTS:We found LSV to be relatively prevalent (10% (14 of 140) among surviving babies). More importantly, it was significantly associated with the occurrence of neonatal IVH, even when controlled for possible confounding (adjusted OR 9.8, 95% confidence interval 1.3 to 73.1; p ¼ 0.03). CONCLUSION:Given the known relationships between IVH and neonatal morbidity and mortality, the finding of a statistically significant association between neonatal IVH and LSV may suggest more substantial implications for the latter than previously believed.

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Section: Introductionsupporting

confidence: 79%

Section: Introductionmentioning

confidence: 95%

Association between Lenticulostriate Vasculopathy (LSV) and Neonatal Intraventricular Hemorrhage (IVH)

et al. 2004

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“…By definition, LSV consists of bright, echogenic, linear blood vessels in the basal ganglia and thalami. Neuropathological correlates of LSV include thickened and hypercellular blood vessel walls having intramural and perivascular mineralization, 30 as well as adventitial or subendothelial deposits of amorphous, basophilic material in small-and medium-sized arteries. 31 Of interest, LSV was first reported in the 1960s after a congenital rubella epidemic in Philadelphia.…”

Section: Lenticulostriate Vasculopathymentioning

confidence: 99%

Brain lesions in newborns exposed to high-dose magnesium sulfate during preterm labor

Mittendorf

Dammann

2005

J Perinatol

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High-dosage, tocolytic magnesium sulfate (MgSO 4 ) administered to pregnant women during preterm labor can be toxic, and sometimes lethal, for their newborns (Cochrane Database of Systematic Reviews (relative mortality risk 2.82, 95% confidence interval 1.2-6.6)). Based on the results of the Magnesium and Neurologic Endpoints Trial and the work of many others, a unifying triangular concept is proposed to account for the increased prevalence of brain lesions, with their likely resultant mortality, in neonates and infants exposed to high-dose MgSO 4 in the context of preterm labor. We review the evidence that: (1) elevated circulating levels of serum ionized magnesium occurring in mothers, and therefore in their babies, at the time of delivery are associated with subsequent neonatal intraventricular hemorrhage (IVH); (2) neonatal IVH is strongly associated with lenticulostriate vasculopathy (LSV), an unusual mineralizing lesion involving the thalami and basal ganglia of the neonate; and, (3) exposure to 50 g or more of tocolytic MgSO 4 during preterm labor is associated with the development of LSV.

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“…1,2,[8][9][10][11][12][13][14][15][16][17][18][19][20][21][22][23][24] Basal ganglia hemorrhage results from periventricular hemorrhagic infarction or hemorrhagic necrosis. In preterm infants <28 weeks, diffuse caudate hemorrhage is difficult to differentiate from hemorrhage in the germinal matrix over the body of the caudate nucleus (grade I).…”

Section: Introductionmentioning

confidence: 99%

Diffuse basal ganglia or thalamus hyperechogenicity in preterm infants

et al. 2006

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Objective: To determine the incidence and factors associated with diffuse basal ganglia or thalamus hyperechogenicity (BGTH) in preterm infants.Study Design: (1) Review of serial neurosonograms among neonates with gestational age (GA) <34 weeks born at Weiler Hospital during a 21-month period; (2) Color Doppler flow imaging; (3) Case-control study using GA group-matched controls; and (4) Blind reading of CT scans or MRIs in patients with BGTH.Results: Among 289 infants, 24 (8.3%) had diffuse BGTH. Color Doppler flow imaging was normal in nine patients. The incidence of diffuse BGTH was inversely related to GA (P<0.01). Logistic regression (n ¼ 96) showed that diffuse BGTH was significantly associated with requirement of high-frequency oscillation (HFO) (P ¼ 0.031), severe intraventricular hemorrhage (IVH) (P ¼ 0.004), hypotension requiring vasopressors (P ¼ 0.040), hypoglycemia (P ¼ 0.031) and male gender (P ¼ 0.014). Most patients with diffuse BGTH had normal basal ganglia and thalamus on CT/MRI, one had a hemorrhage, and one had an ischemic infarction.Conclusions: In our series, diffuse BGTH occurred in 8.3%, and was associated with factors similar to those previously reported. In contrast, several series have reported almost exclusively linear or punctuate hyperechoic foci, corresponding to hyperechogenicity of the lenticulostriate vessels. Our data provide further evidence to suggest that diffuse BGTH and hyperechogenicity of the lenticulostriate vessels are two different entities. Additional studies are required to determine the longterm significance of diffuse BGTH.

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Importance of hypoxic/ischemic conditions in the development of cerebral lenticulostriate vasculopathy

Abstract: LSV has varied clinical associations. The common association with hypoxic/ischemic conditions and the progressive changes seen in 12 patients with cardiac and pulmonary disease suggest that postnatal hypoxia/ischemia is an important etiologic factor.

Cited by 50 publications

References 0 publications

Association between Lenticulostriate Vasculopathy (LSV) and Neonatal Intraventricular Hemorrhage (IVH)

Association between Lenticulostriate Vasculopathy (LSV) and Neonatal Intraventricular Hemorrhage (IVH)

Brain lesions in newborns exposed to high-dose magnesium sulfate during preterm labor

Diffuse basal ganglia or thalamus hyperechogenicity in preterm infants

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