Patrick Kelly1, Rebecca Hayman2, Lara S Shekerdemian3, Peter Reed4, Ayton Hope5, Julia Gunn6, Lee Coleman7, John Beca8. 1. Te Puaruruhau (Child Protection Team), Department of Pediatrics, Faculty of Medical and Health Sciences, University of Auckland, New Zealand; patrickk@adhb.govt.nz. 2. Children's Emergency Department. 3. Section of Critical Care Medicine, Texas Children's Hospital, Houston, Texas; 4. Children's Research Centre, and. 5. Department of Neuroradiology, Auckland City Hospital, Auckland, New Zealand; 6. Departments of Neonatal Medicine, and Murdoch Children's Research Institute, Melbourne, Australia. 7. Radiology, The Royal Children's Hospital, Melbourne, Australia; and. 8. Pediatric ICU, Starship Children's Hospital, Auckland, New Zealand;
Abstract
BACKGROUND AND OBJECTIVES: It has been suggested that there is a causal relationship between hypoxia and subdural hemorrhage (SDH) in infancy. The purpose of this study was to review the incidence of SDH in infants with congenital heart disease and explore the relationship between SDH and hypoxia. METHODS: Review of data collected for a prospective longitudinal cohort study of infants undergoing surgery for congenital heart disease in New Zealand and Australia. Infants underwent serial MRI scans of the brain in the first 3 months of life. All oxygen saturation recordings and MRI results were extracted and infants assigned to categories by degree of hypoxia. The data were then examined for any statistically significant relationship between hypoxia and SDH. RESULTS: One hundred fifty-two infants underwent MRI scans, and 66 (43%) had 145 loci of SDH. New SDH was seen in 12 infants after cardiac surgery. Of the loci of SDH, 63 (43%) were supratentorial, and most of these were interhemispheric, parietal, or temporal. SDH present on the first MRI persisted beyond 28 days of life in 8 infants. There was no demonstrable relationship between SDH and hypoxia. CONCLUSIONS: Asymptomatic SDH is common in young infants with congenital heart disease, at a frequency similar to that of those without congenital heart disease. These SDHs may occur in locations where they occur in abusive head trauma, but they are typically small and resolve within 3 months of birth. We were unable to demonstrate any association between hypoxia and SDH in this cohort.
BACKGROUND AND OBJECTIVES: It has been suggested that there is a causal relationship between hypoxia and subdural hemorrhage (SDH) in infancy. The purpose of this study was to review the incidence of SDH in infants with congenital heart disease and explore the relationship between SDH and hypoxia. METHODS: Review of data collected for a prospective longitudinal cohort study of infants undergoing surgery for congenital heart disease in New Zealand and Australia. Infants underwent serial MRI scans of the brain in the first 3 months of life. All oxygen saturation recordings and MRI results were extracted and infants assigned to categories by degree of hypoxia. The data were then examined for any statistically significant relationship between hypoxia and SDH. RESULTS: One hundred fifty-two infants underwent MRI scans, and 66 (43%) had 145 loci of SDH. New SDH was seen in 12 infants after cardiac surgery. Of the loci of SDH, 63 (43%) were supratentorial, and most of these were interhemispheric, parietal, or temporal. SDH present on the first MRI persisted beyond 28 days of life in 8 infants. There was no demonstrable relationship between SDH and hypoxia. CONCLUSIONS: Asymptomatic SDH is common in young infants with congenital heart disease, at a frequency similar to that of those without congenital heart disease. These SDHs may occur in locations where they occur in abusive head trauma, but they are typically small and resolve within 3 months of birth. We were unable to demonstrate any association between hypoxia and SDH in this cohort.
Authors: R Stegeman; M Feldmann; N H P Claessens; N J G Jansen; J M P J Breur; L S de Vries; T Logeswaran; B Reich; W Knirsch; R Kottke; C Hagmann; B Latal; J Simpson; K Pushparajah; A F Bonthrone; C J Kelly; S Arulkumaran; M A Rutherford; S J Counsell; M J N L Benders Journal: AJNR Am J Neuroradiol Date: 2021-10-21 Impact factor: 3.825
Authors: Olivia Carney; Emer Hughes; Nora Tusor; Ralica Dimitrova; Sophie Arulkumaran; Kelly Pegoretti Baruteau; Alexia Egloff Collado; Lucilio Cordero-Grande; Andrew Chew; Shona Falconer; Joanna M Allsop; Daniel Rueckert; Joseph Hajnal; A David Edwards; Mary Rutherford Journal: EClinicalMedicine Date: 2021-07-20