Lenticulostriate echogenic vessels: clinical and sonographic study of 70 neonatal cases.
BACKGROUND
Neonatal branching echogenic streaks in the basal ganglia or 'lenticulostriate vasculopathy' (LSV) has no clear comprehensive aetiology.


OBJECTIVE
To provide some clinical evidence, possibly relevant to aetiology, by analysis of a large series.


METHODS
Seventy cases (9 deaths, 3 post mortem) identified between 1981 and 2000 out of 9,138 neonates with routine brain sonograms (578 in a protocol for neonates from HIV+ mothers). Review of maternal/neonatal charts for clinical data and serologic status. Retrospective analysis of sonograms for grading and time course of LSV and coexistent abnormalities.


RESULTS
LSV was unilateral in 31 cases (22 right), bilateral in 39. Grading separated 8 major, 27 moderate and 35 minor patterns. In 42 cases, LSV was isolated, and in 28 it was mixed with peri-intraventricular haemorrhage grades I or II and/or leucomalacia. LSV was detected in the first postnatal week in 56 instances and appeared later in 13. Disappearance occurred mostly within 2 months. Perinatal circumstances: 13 recipient monochorionic twins (polycythaemia from twin-twin transfusion syndromes), 20 HIV+ mothers (possible immunological disturbances; only 2 infected neonates), 10 congenital anomalies, 1 toxoplasmosis, 1 postnatal cytomegalovirus infection, 25 miscellaneous conditions. Numerous maternal and neonatal factors were non-contributory.


CONCLUSIONS
These results do not support congenital toxoplasmosis, rubella, cytomegalovirus, and herpes (TORCH) infections as the main causative factor. Polycythaemia and various immunological disturbances may be involved, as well as infectious agents not appropriately screened by routine serodiagnoses.
El Ayoubi
Mayass
M
Port-Royal Neonatal Intensive Care Unit, Centre Hospitalier Universitaire Cochin/Saint Vincent de Paul/La Roche Guyon, 123 Boulevard de Port-Royal, 75679 Paris Cedex 14, France. secret.neonat@cch.ap-hop-paris.fr
de Bethmann
Odile
O
Monset-Couchard
Michèle
M
D000328:Adult; D020144:Basal Ganglia Cerebrovascular Disease / Q000000981:diagnostic imaging* / Q000209:etiology; D001921:Brain / Q000098:blood supply*; D005260:Female; D006801:Humans; D007231:Infant, Newborn; D008297:Male; D011247:Pregnancy; D017585:Ultrasonography, Doppler, Transcranial; D016216:Ultrasonography, Prenatal