title: Serial cranial US for detection of cerebral sinovenous thrombosis in preterm infants.
abstract: OBJECTIVE
  To report the incidence of cerebral sinovenous thrombosis (CSVT) in a prospective cohort of preterm infants with a gestational age of less than 29 weeks.
  
  
  METHODS
  The local medical ethics review board approved this study, and written parental consent was obtained. Preterm infants with a gestational age of less than 29 weeks who were admitted to the neonatal intensive care unit were prospectively studied with cranial ultrasonography (US). The scanning protocol included visualization with color Doppler imaging of the superior sagittal sinus and transverse sinuses through the anterior (8.5-MHz probe) and mastoid (13-MHz probe) fontanelles. When feasible, magnetic resonance imaging was performed to confirm cranial US-diagnosed CSVT. The differences between preterm infants with and those without CSVT were analyzed by using Mann-Whitney tests for continuous variables and Fisher exact tests for categorical data.
  
  
  RESULTS
  Cranial US was used to document CSVT in 11 of 249 preterm infants with a gestational age of less than 29 weeks. Transverse sinuses were most frequently affected (in all 11 patients with CSVT). All infants with CSVT were asymptomatic. Postnatal age at diagnosis ranged from 5 to 34 days. The mean gestational age was significantly lower in infants with CSVT (25.9 weeks vs 26.8 weeks, P = .038). Of the risk factors studied, only duration of mechanical ventilation was associated with CSVT; it was significantly longer in the CSVT group.
  
  
  CONCLUSIONS
  Systematic serial cranial US of infants with a gestational age of less than 29 weeks showed a remarkably high incidence of CSVT of 4.4%. Cranial US including color Doppler imaging with scans obtained through the mastoid fontanelle can depict CSVT at an early stage. Treatment of this possibly important condition needs attention.
authors.affiliation: From the Departments of Neonatology (M.M.A.R., J.J.S., P.G., I.K.M.R., A.A.K., J.D.), Pediatric Radiology (M.H.L., J.D.), and Hematology (I.M.A.), Erasmus MC-Sophia Children's Hospital Rotterdam, Dr Molewaterplein 60, 3015 GJ Rotterdam, the Netherlands; and Department of Pediatrics, Koningin Paola Children's Hospital, Antwerp, Belgium (P.G.).
authors.forename: Marlou M A
authors.initials: MM
authors.lastname: Raets
authors.forename: Jeanine J
authors.initials: JJ
authors.lastname: Sol
authors.forename: Paul
authors.initials: P
authors.lastname: Govaert
authors.forename: Maarten H
authors.initials: MH
authors.lastname: Lequin
authors.forename: Irwin K M
authors.initials: IK
authors.lastname: Reiss
authors.forename: Andreas A
authors.initials: AA
authors.lastname: Kroon
authors.forename: Inge M
authors.initials: IM
authors.lastname: Appel
authors.forename: Jeroen
authors.initials: J
authors.lastname: Dudink
mesh_terms: D005260:Female; D005865:Gestational Age; D006801:Humans; D007231:Infant, Newborn; D007234:Infant, Premature; D007363:Intensive Care Units, Neonatal; D008279:Magnetic Resonance Imaging; D008297:Male; D011446:Prospective Studies; D012851:Sinus Thrombosis, Intracranial / Q000000981:diagnostic imaging*; D018615:Ultrasonography, Doppler, Color