Serial Cranial US for Detection of Cerebral Sinovenous Thrombosis in Preterm Infants

Raets, Marlou M. A.; Sol, Jeanine J.; Govaert, Paul; Lequin, Maarten H.; Kroon, AA; Appel, Inge M.; Dudink, Jeroen

doi:10.1148/radiology.13130401

Cited by 16 publications

(29 citation statements)

References 26 publications

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“…3 However, subtle changes in a HUS (DOL 17) were not obvious in this case until retrospective review, delaying further testing and therapy. Computed tomography for CSVT detection has also suboptimal sensitivity and high ionizing radiation exposure.…”

Section: Discussionmentioning

confidence: 79%

“…2,3 The little available evidence suggests that withholding anticoagulation increases the risk of thrombus propagation, 2 whereas anticoagulation therapy does not increase new bleeding. In the Canadian Pediatric Ischemic Stroke Registry (CPISR), no infant died or showed deterioration from bleeding while receiving anticoagulation.…”

Section: Discussionmentioning

confidence: 99%

“…2 In premature infants, CSVT incidence has been reported as high as 4.4% using head ultrasound (HUS) with Doppler scan through the mastoid fontanelle confirmed with magnetic resonance imaging (MRI). 3 The superior sagittal and transverse lateral sinuses are the most common CSVT sites. 4,5 CSVT accompanied by spinal cord injury has never been reported in premature neonates.…”

Section: Introductionmentioning

confidence: 99%

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Acute paraplegia in a preterm infant with cerebral sinovenous thrombosis

et al. 2015

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We report the case of a 1-month old, 28-week gestational age infant who presented with acute paraplegia after cardiopulmonary arrest. Later imaging confirms cerebral sinovenous thrombosis (CSVT) and a suspected infarction in the conus medullaris of the spinal cord. A prothrombotic state may explain the numerous areas of infarction visualized on neuroimaging. To our knowledge this is the first case report of acute and persistent paraplegia in an infant with CSVT and conus medullaris injury, which may be due to venous infarction of the spinal cord.

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Section: Discussionmentioning

confidence: 79%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Acute paraplegia in a preterm infant with cerebral sinovenous thrombosis

et al. 2015

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“…Flow velocities can be evaluated and indices obtained. Doppler CUS permits detection of cerebral sinovenous thrombosis at an early stage in the fragile transverse to sigmoid sinus angle, allowing therapeutic intervention prior to stroke 2 . Use of supplemental acoustic windows enhances detection of brain injury.…”

Section: Discussionmentioning

confidence: 99%

“…Examples of these supplemental acoustic windows are the lambdoid (posterior), mastoid and lateral (temporal) fontanels. So far, however, only few NICUs use these additional acoustic windows routinely [2][3][4][5] . Doppler techniques can be used for screening patency of intracranial vessels.…”

Section: Introductionmentioning

confidence: 99%

State of the Art Cranial Ultrasound Imaging in Neonates

Ecury-Goossen

Camfferman

Leijser

et al. 2015

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Cranial ultrasound (CUS) is a reputable tool for brain imaging in critically ill neonates. It is safe, relatively cheap and easy to use, even when a patient is unstable. In addition it is radiation-free and allows serial imaging. CUS possibilities have steadily expanded. However, in many neonatal intensive care units, these possibilities are not optimally used. We present a comprehensive approach for neonatal CUS, focusing on optimal settings, different probes, multiple acoustic windows and Doppler techniques. This approach is suited for both routine clinical practice and research purposes. In a live demonstration, we show how this technique is performed in the neonatal intensive care unit. Using optimal settings and probes allows for better imaging quality and improves the diagnostic value of CUS in experienced hands. Traditionally, images are obtained through the anterior fontanel. Use of supplemental acoustic windows (lambdoid, mastoid, and lateral fontanels) improves detection of brain injury. Adding Doppler studies allows screening of patency of large intracranial arteries and veins. Flow velocities and indices can be obtained. Doppler CUS offers the possibility of detecting cerebral sinovenous thrombosis at an early stage, creating a window for therapeutic intervention prior to thrombosis-induced tissue damage. Equipment, data storage and safety aspects are also addressed. Video LinkThe video component of this article can be found at

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