Subpial hemorrhages in neonates: imaging features, clinical factors and outcomes

Abstract

Neonatal subpial hemorrhage is a poorly understood type of intracranial hemorrhage. Herein, we reported on 34 neonates with subpial hemorrhages, focusing on the imaging features, clinical factors, and outcomes of this type of intracranial hemorrhage. This retrospective case series enrolled 34 neonates with subpial hemorrhages. We analyzed their magnetic resonance (MR) images, clinical manifestations, and prognoses. We categorized, for the first time, the MR images of patients with subpial hemorrhages into three imaging patterns; moreover, on the basis of a yin-yang sign, we added a sandwich sign, attaining an MR image feature that was easier to understand. MR Patterns A and B both have good prognoses, and most patients had normal clinical outcomes. Subpial hemorrhage in neonates may be diagnosed via imaging patterns. Recognizing this pattern of hemorrhage may help gain a better understanding of the associated risk factors.

Temporal Evolution of Subpial Hemorrhage in Neonate

“…The veins in the subpial space have a paucity of the trabecular network; hence a venous injury results in direct decompression of superficial hemorrhage and subsequent contiguous dissection along the subpial space. [ 2 , 3 ] Additional clinical evidence is in the absence of xanthochromia in CSF samples of patients with subpial hemorrhage.…”