Nathalie H P Claessens1, Selma O Algra2, Nicolaas J G Jansen3, Floris Groenendaal4, Esther de Wit3, Alexander A Wilbrink3, Felix Haas5, Antonius N J Schouten6, Rutger A J Nievelstein2, Manon J N L Benders4, Linda S de Vries7. 1. Division of Perinatology, Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands; Division of Pediatrics, Department of Paediatric Intensive Care, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands; Division of Pediatrics, Department of Pediatric Cardiology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands. 2. Division of Imaging, Department of Radiology, University Medical Centre Utrecht, Utrecht, The Netherlands. 3. Division of Pediatrics, Department of Paediatric Intensive Care, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands. 4. Division of Perinatology, Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands. 5. Division of Pediatrics, Department of Pediatric Cardiothoracic Surgery, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands. 6. Department of Anesthesiology, University Medical Centre Utrecht, Utrecht, The Netherlands. 7. Division of Perinatology, Department of Neonatology, Wilhelmina Children's Hospital, University Medical Centre Utrecht, Utrecht, The Netherlands. Electronic address: l.s.devries@umcutrecht.nl.
Abstract
OBJECTIVES: Neonates with congenital heart disease may have an increased risk of cerebral sinovenous thrombosis, but incidence rates are lacking. This study describes the clinical and neuroimaging characteristics of cerebral sinovenous thrombosis in neonates undergoing cardiac surgery. METHODS: Forty neonates (78% male) requiring neonatal univentricular or biventricular cardiac repair using cardiopulmonary bypass were included. All underwent preoperative (median postnatal day 7) and postoperative (median postoperative day 7) magnetic resonance imaging of the brain, including venography, to detect cerebral sinovenous thrombosis. Clinical characteristics were compared between cerebral sinovenous thrombosis positive and cerebral sinovenous thrombosis negative neonates. RESULTS: Postoperatively, cerebral sinovenous thrombosis was diagnosed in 11 neonates (28%), with the transverse sinus affected in all, and involvement of multiple sinuses in 10 (91%). Preoperatively, signs of thrombosis were seen in 3 cases (8%). Focal infarction of the basal ganglia was significantly more common in cerebral sinovenous thrombosis positive than cerebral sinovenous thrombosis negative neonates (P = .025). Cerebral sinovenous thrombosis positive neonates spent more time in the intensive care unit preoperatively (P = .001), had lower weight (P = .024) and lower postmenstrual age (P = .030) at surgery, and had prolonged use of a central venous catheter (P = .023) and a catheter placed in the internal jugular vein more often (P = .039). Surgical and postoperative factors were not different between new postoperative cerebral sinovenous thrombosis positive and cerebral sinovenous thrombosis negative neonates. CONCLUSIONS: Cerebral sinovenous thrombosis might be more common than previously understood in neonates undergoing cardiac surgery. In our study, cerebral sinovenous thrombosis was associated with a higher risk of additional intra-parenchymal brain injury.
OBJECTIVES: Neonates with congenital heart disease may have an increased risk of cerebral sinovenous thrombosis, but incidence rates are lacking. This study describes the clinical and neuroimaging characteristics of cerebral sinovenous thrombosis in neonates undergoing cardiac surgery. METHODS: Forty neonates (78% male) requiring neonatal univentricular or biventricular cardiac repair using cardiopulmonary bypass were included. All underwent preoperative (median postnatal day 7) and postoperative (median postoperative day 7) magnetic resonance imaging of the brain, including venography, to detect cerebral sinovenous thrombosis. Clinical characteristics were compared between cerebral sinovenous thrombosis positive and cerebral sinovenous thrombosis negative neonates. RESULTS: Postoperatively, cerebral sinovenous thrombosis was diagnosed in 11 neonates (28%), with the transverse sinus affected in all, and involvement of multiple sinuses in 10 (91%). Preoperatively, signs of thrombosis were seen in 3 cases (8%). Focal infarction of the basal ganglia was significantly more common in cerebral sinovenous thrombosis positive than cerebral sinovenous thrombosis negative neonates (P = .025). Cerebral sinovenous thrombosis positive neonates spent more time in the intensive care unit preoperatively (P = .001), had lower weight (P = .024) and lower postmenstrual age (P = .030) at surgery, and had prolonged use of a central venous catheter (P = .023) and a catheter placed in the internal jugular vein more often (P = .039). Surgical and postoperative factors were not different between new postoperative cerebral sinovenous thrombosis positive and cerebral sinovenous thrombosis negative neonates. CONCLUSIONS:Cerebral sinovenous thrombosis might be more common than previously understood in neonates undergoing cardiac surgery. In our study, cerebral sinovenous thrombosis was associated with a higher risk of additional intra-parenchymal brain injury.
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: Christopher J Kelly; Sophie Arulkumaran; Catarina Tristão Pereira; Lucilio Cordero-Grande; Emer J Hughes; Rui Pedro A G Teixeira; Johannes K Steinweg; Suresh Victor; Kuberan Pushparajah; Joseph V Hajnal; John Simpson; A David Edwards; Mary A Rutherford; Serena J Counsell Journal: Arch Dis Child Date: 2019-06-26 Impact factor: 3.791
Authors: Nadieh Khalili; E Turk; M J N L Benders; P Moeskops; N H P Claessens; R de Heus; A Franx; N Wagenaar; J M P J Breur; M A Viergever; I Išgum Journal: Neuroimage Clin Date: 2019-11-09 Impact factor: 4.881
Authors: Hüseyin Çaksen; Fatma Tuba Köseoğlu; Ahmet Sami Güven; Hüseyin Altunhan; Mehmet Sinan İyisoy; Saim Açıkgözoğlu Journal: Ann Indian Acad Neurol Date: 2021-04-05 Impact factor: 1.383