[Venous infarction of the neonate].
OBJECTIVE
To determine the imaging features of hemorrhagic infarction in neonates.


METHODS
Retrospective study (1998-2008) of 19 children (17 premature and 2 term deliveries) with early lobar hyperechogenicity on transfontanel US (TFUS). Group I: 11 born infants with clinical as well as TFUS and MRI follow-up. Group II: 8 premature infants deceased within a week from multisystem pathology, with neuropathological study available in 3 cases.


RESULTS
Group I (n=11): periventricular hyperechogenicity in a frontal (7), frontoparietal (2), parietooccipital (1) and temporoparietal (1) distribution with developing cavitary change (n=6). MRI showed a cortex sparing intraparenchymal hematoma. Group II (n=8): periventricular hyperechogenicity in a frontal (4), frontoparietal or parietal (3) and occipital (1) with developing cavitary change (3). Neuropathological examination showed characteristic lesions of venous hemorrhagic infarction. Clinical outcome was generally favorable for the surviving infants with contralateral motor deficit (n=5) non-correlated to the extent of the initial lesions.


CONCLUSIONS
Venous hemorrhagic infarction mainly affetcs premature infants and typically involves the periventricular frontal white matter. Prognosis is generally favorable. It is thus important to differentiate this entity from asymmetrical cystic periventricular leukomalacia with much different prognosis.
Lahutte
M
M
Service d'Imagerie Pédiatrique, Hôpital St-Vincent-de-Paul, Université Paris Descartes, Faculté de Médecine, AP-HP, 82, avenue Denfert Rochereau, 75674 Paris cedex 14, France.
Bordarier
C
C
Hornoy
P
P
Fallet-Bianco
C
C
Adamsbaum
C
C
D001724:Birth Weight; D002543:Cerebral Hemorrhage / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D002544:Cerebral Infarction / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D003937:Diagnosis, Differential; D004453:Echoencephalography / Q000379:methods*; D005260:Female; D005500:Follow-Up Studies; D006406:Hematoma / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007235:Infant, Premature, Diseases / Q000175:diagnosis* / Q000000981:diagnostic imaging*; D008279:Magnetic Resonance Imaging; D008297:Male; D017063:Outcome Assessment, Health Care; D012189:Retrospective Studies