title: Posterior fossa intracranial hemorrhage in infants treated with extracorporeal membrane oxygenation: sonographic findings.
abstract: Posterior fossa hemorrhage was documented by autopsy in five infants who had been treated with extracorporeal membrane oxygenation over a 5-year-period. In all five cases, the diagnosis was made prospectively by cranial sonography. Sonographic findings were compared with those in a control group of 15 infants with normal posterior fossae at autopsy. The following sonographic abnormalities were exhibited in neonates with posterior fossae hemorrhage: loss of definition of the cerebellum and fourth ventricle on midline sagittal images, heterogeneous cerebellar parenchyma, focal hypoechoic lesions, ventricular dilatation, and tentorial abnormalities. Bright foci inferior to the third ventricle were seen in four neonates in the normal control group. These foci measured 5-10 mm in diameter. One cranial sonogram was falsely interpreted as showing a posterior fossa hemorrhage because of prominent echoes in the interpeduncular cistern. Infants treated with extracorporeal membrane oxygenation are at risk for developing posterior fossa hemorrhage. Awareness of sonographic signs and potential pitfalls in the interpretation of posterior fossa hemorrhage is important for early and accurate recognition of these unusual and sometimes treatable hemorrhages.
authors.affiliation: Department of Diagnostic Imaging and Radiology, Children's National Medicine Center, Washington, DC 20010-2970.
authors.forename: D I
authors.initials: DI
authors.lastname: Bulas
authors.forename: G A
authors.initials: GA
authors.lastname: Taylor
authors.forename: C R
authors.initials: CR
authors.lastname: Fitz
authors.forename: M E
authors.initials: ME
authors.lastname: Revenis
authors.forename: P
authors.initials: P
authors.lastname: Glass
authors.forename: J D
authors.initials: JD
authors.lastname: Ingram
mesh_terms: D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging* / Q000453:epidemiology / Q000209:etiology*; D003388:Cranial Fossa, Posterior; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects*; D006801:Humans; D007231:Infant, Newborn; D012127:Respiratory Distress Syndrome, Newborn / Q000628:therapy; D012307:Risk Factors; D014463:Ultrasonography