Sonographic lenticulostriate vasculopathy in infants: some associations and a hypothesis.
OBJECTIVE
To describe the causes of infantile lenticulostriate vasculopathy (LSV) as demonstrated by sonography and propose the pathogenesis of these findings.


METHODS
Five hundred eighty-six infants were examined via echoencephalography because of seizures, psychomotor retardation, dysmorphism, congenital malformation, microcephaly, macrocephaly, bulging of anterior fontanel, consciousness disturbance, or prematurity. We directed our attention on the sonographic study to the basal ganglionic and thalamic areas. Twenty-eight of the 586 patients underwent color Doppler studies.


RESULTS
In 34 infants with gray-scale neurosonographic findings of LSV, 16 were associated with various causes that have been reported before. In 8 patients entities not previously associated with LSV were found: neonatal lupus, neonatal hypoglycemia, uncomplicated prematurity, encephalitis, and head injury. In the remaining 10 cases, a specific cause could not be found. The LSV was found in 16 (40%), 5 (14%), and 13 (3%) patients with perinatal, acquired, and nonspecific causes, respectively. Generally, this is an uncommon finding because it was observed in only 34 (5.8%) of the study infants; 24 of these 34 had a documented cause of the vasculopathy. With LSV associated with perinatal causes there was a greater chance of sonographic LSV's developing than with that of acquired causes.


CONCLUSIONS
We suggest that sonographic LSV is a nonspecific marker of a previous insult to the developing brain, and the special hemodynamics of the fetal brain plays an important role in its pathogenesis.
Wang
H S
HS
Department of Pediatrics, Chang Gung Medical College, Taipei, Taiwan.
Kuo
M F
MF
Chang
T C
TC
D001479:Basal Ganglia / Q000000981:diagnostic imaging; D001720:Birth Injuries / Q000000981:diagnostic imaging; D001921:Brain / Q000002:abnormalities; D001927:Brain Diseases / Q000000981:diagnostic imaging; D002561:Cerebrovascular Disorders / Q000151:congenital / Q000000981:diagnostic imaging*; D003244:Consciousness Disorders / Q000000981:diagnostic imaging; D003342:Corpus Striatum / Q000098:blood supply* / Q000000981:diagnostic imaging*; D004453:Echoencephalography; D004660:Encephalitis / Q000000981:diagnostic imaging; D005147:Facial Bones / Q000002:abnormalities; D016489:Head Injuries, Closed / Q000000981:diagnostic imaging; D006801:Humans; D007003:Hypoglycemia / Q000000981:diagnostic imaging; D007223:Infant; D007231:Infant, Newborn; D007234:Infant, Premature; D008180:Lupus Erythematosus, Systemic / Q000000981:diagnostic imaging; D008831:Microcephaly / Q000000981:diagnostic imaging; D011596:Psychomotor Disorders / Q000000981:diagnostic imaging; D012189:Retrospective Studies; D012640:Seizures / Q000000981:diagnostic imaging; D012886:Skull / Q000002:abnormalities; D013788:Thalamus / Q000000981:diagnostic imaging; D018615:Ultrasonography, Doppler, Color