NDLI: Anticoagulation therapy and imaging in neonates with a unilateral thalamic hemorrhage due to cerebral sinovenous thrombosis.

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Anticoagulation therapy and imaging in neonates with a unilateral thalamic hemorrhage due to cerebral sinovenous thrombosis.

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Anticoagulation therapy and imaging in neonates with a unilateral thalamic hemorrhage due to cerebral sinovenous thrombosis.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Groenendaal, Floris Kersbergen, Karina J. de Vries, Linda S. Benders, Manon J. N. L. Van Straaten, H. L. M. Irma Nievelstein, Rutger A. J.
Description	Country affiliation: Netherlands Author Affiliation: Kersbergen KJ ( Department of Neonatology, KE 04.123.1, University Medical Center Utrecht/Wilhelmina Children's Hospital, Lundlaan 6, 3584 EA Utrecht, The Netherlands.)
Abstract	BACKGROUND AND PURPOSE: Cerebral sinovenous thrombosis is a rare disorder with a high risk of an adverse neurodevelopmental outcome. Until now, anticoagulation therapy has been restricted to neonates without an associated parenchymal hemorrhage. In this study, we describe sequential neuroimaging findings and use of anticoagulation therapy in newborn infants with a unilateral thalamic hemorrhage due to cerebral sinovenous thrombosis. METHODS: Ten neonates with a unilateral thalamic hemorrhage and cerebral sinovenous thrombosis were studied. Diagnosis was suspected using cranial ultrasound and confirmed with MRI/MR venography. Eight infants had a repeat MRI at 3 to 7 months. Neurodevelopmental outcome was assessed from 3 months until 5 years. RESULTS: One infant died. Seven infants were treated with low-molecular-weight heparin. No side affects were noted. MRI showed involvement of multiple sinuses, additional intraventricular hemorrhage, and white matter lesions in all infants. Recanalization was present on the repeat MRI at 3 months in all infants. Treatment was delayed in one infant and anticoagulation was started only after extension of the thalamic hemorrhage. He required a ventriculoperitoneal drain for posthemorrhagic ventricular dilatation and developed cerebral visual impairment and global delay. Two other infants showed global delay and one of them also developed postneonatal epilepsy. Mild asymmetry in tone was present in 4 children. CONCLUSIONS: Cerebral sinovenous thrombosis was found in 10 neonates with unilateral thalamic hemorrhage. Diagnosis was suspected on cranial ultrasound and confirmed with MRI/MR venography. Treatment with low-molecular-weight heparin in newborn infants with a thalamic hemorrhage due to cerebral sinovenous thrombosis appears to be safe and should be considered. Long-term follow-up will be needed to assess cognitive outcome.
ISSN	00392499
e-ISSN	15244628
Journal	Stroke
Issue Number	8
Volume Number	40
Language	English
Publisher	Lippincott Williams & Wilkins (on behalf of the American Heart Association)
Publisher Date	2009-08-01
Publisher Place	United States
Access Restriction	Open
Subject Keyword	Anticoagulants Therapeutic Use Cerebral Hemorrhage Diagnosis Drug Therapy Sinus Thrombosis, Intracranial Thalamic Diseases Etiology Child, Preschool Infant Infant, Newborn Magnetic Resonance Angiography Magnetic Resonance Imaging Complications Ultrasonography, Doppler Comparative Study Discipline Cardiology
Content Type	Text
Resource Type	Article
Subject	Cardiology and Cardiovascular Medicine Neuroscience Advanced and Specialized Nursing Neurology (clinical)

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