title: Cerebral microbleeds after use of extracorporeal membrane oxygenation in children.
abstract: Cerebral microbleeds (CMB) on gradient-recalled echo (GRE) magnetic resonance imaging (MRI) are rarely seen in children, yet have been described following vascular procedures in adults. Extracorporeal membrane oxygenation (ECMO) has been associated with vascular injury and neurological events in children, but there have been no reports to date of GRE MRI findings in children treated with ECMO. We reviewed MRI scans for all vascular neurology consultations in children treated with ECMO at an academic medical center over a 5-year period. In 6 of 12 cases, GRE was acquired as others were unstable or had contraindications to MRI. All 6 of 6 (100%) GRE cases (mean age 2.1 years, 7 female, 5 male) demonstrated CMB. CMB were multiple (>3 lesions), situated in cortical or lobar regions, with a striking predominance (5/6 cases) for the right carotid distribution. Other than CMB, no cases demonstrated intracranial hemorrhage. CMB may be noted on GRE MRI after ECMO and may reflect vascular damage from gaseous emboli.
authors.affiliation: UCLA Stroke Center, University of California Los Angeles, Los Angeles, CA 90095-1769, USA. davidliebeskind@yahoo.com
authors.forename: David S
authors.initials: DS
authors.lastname: Liebeskind
authors.forename: Nerses
authors.initials: N
authors.lastname: Sanossian
authors.forename: Monica L
authors.initials: ML
authors.lastname: Sapo
authors.forename: Jeffrey L
authors.initials: JL
authors.lastname: Saver
mesh_terms: D001921:Brain / Q000473:pathology*; D002543:Cerebral Hemorrhage / Q000209:etiology* / Q000473:pathology*; D002675:Child, Preschool; D015199:Extracorporeal Membrane Oxygenation / Q000009:adverse effects*; D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male