Neuroimaging findings in neonates and infants from superior vena cava obstruction after cardiac operation.
BACKGROUND
Extraventricular obstructive hydrocephalus may develop after superior vena cava obstruction, an uncommon complication after cardiac surgery.


OBJECTIVE
To describe the neuroimaging findings in neonates and infants with superior vena cava thrombosis after cardiac surgery for congenital heart disease.


METHODS
Between 1993 and 2001, 333 neonates and infants in our hospital underwent cardiac surgery, of whom 13 (3.9%) subsequently acquired superior vena cava syndrome. Eleven of these 13 children (7 boys, 4 girls) were evaluated by head ultrasound and computed tomography scans.


RESULTS
One child had normal findings on head ultrasound, and 10 children had extraventricular obstructive hydrocephalus (EVOH). In 6 children, aggravation of the hydrocephalus was noted up to 11.4 months after cardiac surgery; in 3 of them, the hydrocephalus was shunted to the peritoneum. One child had thrombosis of the dural sinuses, and 1 had hemorrhagic infarction. Two children died during follow-up.


CONCLUSIONS
EVOH is a common complication of superior vena cava thrombosis, and head ultrasound should be performed in all neonates and infants with superior vena cava thrombosis after cardiac surgery. Long-term follow-up is needed, as the hydrocephalus may worsen even months after surgery.
Karmazyn
Boaz
B
Department of Pediatric Radiology, Schneider Children's Medical Center of Israel, 14 Kaplan Street, Petah Tiqva 49202, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. bkar@netvision.net.il
Dagan
Ovdi
O
Vidne
Bernado A
BA
Horev
Gadi
G
Kornreich
Liora
L
D005260:Female; D006330:Heart Defects, Congenital / Q000601:surgery*; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging* / Q000209:etiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D011183:Postoperative Complications / Q000000981:diagnostic imaging*; D012189:Retrospective Studies; D013479:Superior Vena Cava Syndrome / Q000000981:diagnostic imaging* / Q000209:etiology; D014057:Tomography, X-Ray Computed; D020246:Venous Thrombosis / Q000000981:diagnostic imaging* / Q000209:etiology