Boaz Karmazyn1, Ovdi Dagan, Bernado A Vidne, Gadi Horev, Liora Kornreich. 1. Department of Pediatric Radiology, Schneider Children's Medical Center of Israel, 14 Kaplan Street, Petah Tiqva 49202, and Sackler Faculty of Medicine, Tel Aviv University, Tel Aviv, Israel. bkar@netvision.net.il
Abstract
BACKGROUND: Extraventricular obstructive hydrocephalus may develop after superior vena cava obstruction, an uncommon complication after cardiac surgery. OBJECTIVE: To describe the neuroimaging findings in neonates and infants with superior vena cava thrombosis after cardiac surgery for congenital heart disease. MATERIALS AND METHODS: Between 1993 and 2001, 333 neonates and infants in our hospital underwent cardiac surgery, of whom 13 (3.9%) subsequently acquired superior vena cava syndrome. Eleven of these 13 children (7 boys, 4 girls) were evaluated by head ultrasound and computed tomography scans. RESULTS: One child had normal findings on head ultrasound, and 10 children had extraventricular obstructive hydrocephalus (EVOH). In 6 children, aggravation of the hydrocephalus was noted up to 11.4 months after cardiac surgery; in 3 of them, the hydrocephalus was shunted to the peritoneum. One child had thrombosis of the dural sinuses, and 1 had hemorrhagic infarction. Two children died during follow-up. CONCLUSION: EVOH is a common complication of superior vena cava thrombosis, and head ultrasound should be performed in all neonates and infants with superior vena cava thrombosis after cardiac surgery. Long-term follow-up is needed, as the hydrocephalus may worsen even months after surgery.
BACKGROUND: Extraventricular obstructive hydrocephalus may develop after superior vena cava obstruction, an uncommon complication after cardiac surgery. OBJECTIVE: To describe the neuroimaging findings in neonates and infants with superior vena cava thrombosis after cardiac surgery for congenital heart disease. MATERIALS AND METHODS: Between 1993 and 2001, 333 neonates and infants in our hospital underwent cardiac surgery, of whom 13 (3.9%) subsequently acquired superior vena cava syndrome. Eleven of these 13 children (7 boys, 4 girls) were evaluated by head ultrasound and computed tomography scans. RESULTS: One child had normal findings on head ultrasound, and 10 children had extraventricular obstructive hydrocephalus (EVOH). In 6 children, aggravation of the hydrocephalus was noted up to 11.4 months after cardiac surgery; in 3 of them, the hydrocephalus was shunted to the peritoneum. One child had thrombosis of the dural sinuses, and 1 had hemorrhagic infarction. Two children died during follow-up. CONCLUSION:EVOH is a common complication of superior vena cava thrombosis, and head ultrasound should be performed in all neonates and infants with superior vena cava thrombosis after cardiac surgery. Long-term follow-up is needed, as the hydrocephalus may worsen even months after surgery.
Authors: Hannah M Tully; Gisele E Ishak; Tessa C Rue; Jennifer C Dempsey; Samuel R Browd; Kathleen J Millen; Dan Doherty; William B Dobyns Journal: J Child Neurol Date: 2015-07-16 Impact factor: 1.987
Authors: Clinton D Morgan; Michael S Wolf; Truc M Le; Chevis N Shannon; John C Wellons; Bret A Mettler Journal: Childs Nerv Syst Date: 2015-08-18 Impact factor: 1.475