Neonatal venous cerebral hemorrhage. Report of two cases.
Intracranial pathological changes can occur as a result of impaired craniocervical venous return. Thrombosis of central venous access catheters was demonstrated in two neonates born at 38 and 27 weeks' gestation. Neither infant developed hemorrhage of prematurity as confirmed on cranial ultrasonography. Clinical evidence of vena cava thrombosis and associated spontaneous intraventricular hemorrhage developed on Day 24 and 36, respectively, and these findings were confirmed on imaging studies. In one infant the hemorrhage was accompanied by communicating hydrocephalus. The cause of the intracranial disease was attributable to the retrograde cerebral venous congestion. This, together with the primitive venous bed developing in the periventricular region, was associated with the spontaneous hemorrhage in the region of the foramen of Monro. To the authors' knowledge, this is the first report in the English-language literature of spontaneous neonatal intracerebral hemorrhage, due to thrombosis of the superior or inferior vena cava. The natural history of this condition is resolution without sequelae after appropriate therapeutic intervention for the vena cava thrombosis.
Misra
Sanjay N
SN
Department of Neurosurgery, Denver Health Medical Center, University of Colorado Health Sciences Center, Denver, Colorado 80204, USA. Sanjay.Misra@dhha.org
Misra
Ashish K
AK
D000925:Anticoagulants / Q000009:adverse effects / Q000627:therapeutic use; D002405:Catheterization, Central Venous / Q000009:adverse effects; D002543:Cerebral Hemorrhage / Q000000981:diagnostic imaging / Q000209:etiology* / Q000503:physiopathology; D002550:Cerebral Veins / Q000000981:diagnostic imaging / Q000473:pathology*; D002552:Cerebral Ventricles; D005260:Female; D018056:Hemorheology; D006495:Heparin, Low-Molecular-Weight / Q000009:adverse effects / Q000627:therapeutic use; D006801:Humans; D006849:Hydrocephalus / Q000209:etiology; D007231:Infant, Newborn; D007234:Infant, Premature; D012422:Rupture, Spontaneous; D018805:Sepsis / Q000150:complications / Q000628:therapy; D014463:Ultrasonography; D014680:Veins; D014682:Vena Cava, Inferior / Q000000981:diagnostic imaging; D014683:Vena Cava, Superior / Q000000981:diagnostic imaging; D020246:Venous Thrombosis / Q000150:complications* / Q000000981:diagnostic imaging / Q000188:drug therapy
D000925:Anticoagulants; D006495:Heparin, Low-Molecular-Weight