Catarina Pinto1, Bruno Cunha2, Mafalda Mendes Pinto3, Carla Conceição4. 1. Neuroradiology Department, Centro Hospitalar Universitário do Porto, Largo Prof. Abel Salazar, 4099-001, Porto, Portugal. cat.mendes.pinto@gmail.com. 2. Neuroradiology Department, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal. 3. Functional Area of Neuroradiology, Medical Imaging Department, Centro Hospitalar Universitário de Coimbra, Coimbra, Portugal. 4. Neuroradiology Department, Hospital Dona Estefânia, Centro Hospitalar Universitário de Lisboa Central, Lisboa, Portugal.
Abstract
BACKGROUND AND PURPOSE: Subpial hemorrhage is a rare form of neonatal stroke, still poorly understood. The aim of this study was to characterize a cohort of term and preterm neonates with subpial hemorrhages and contribute to a better knowledge of this condition. MATERIAL AND METHODS: Clinical records and magnetic resonance (MR) imaging data of all neonates with subpial hemorrhage followed at a pediatric hospital between 2010 and 2020 were retrospectively reviewed. RESULTS: A total of 10 patients were included in the analysis, 40% of whom were term neonates. Operative vaginal delivery was registered in 30%. Temporal was the most common location of subpial hemorrhage (70%), and all patients displayed underlying brain infarction. A characteristic yin-yang pattern was present in 90% of the study cohort, and ingurgitation of medullary veins on susceptibility weighted imaging in 80%. Cerebellar microbleeds were observed in 60% of neonates, both term and preterm. When available, MR angiography and venography were unremarkable. Patients' clinical outcome was variable, with early prematurity not associated to worse outcomes. CONCLUSION: Subpial hemorrhage has a distinctive MR pattern, with underlying parenchymal venous infarction, and can occur in term and preterm neonates. This study results suggest an association between subpial hemorrhage and cerebellar microbleeds but further studies are required to confirm it and better understand the pathophysiology of subpial hemorrhage.
BACKGROUND AND PURPOSE: Subpial hemorrhage is a rare form of neonatal stroke, still poorly understood. The aim of this study was to characterize a cohort of term and preterm neonates with subpial hemorrhages and contribute to a better knowledge of this condition. MATERIAL AND METHODS: Clinical records and magnetic resonance (MR) imaging data of all neonates with subpial hemorrhage followed at a pediatric hospital between 2010 and 2020 were retrospectively reviewed. RESULTS: A total of 10 patients were included in the analysis, 40% of whom were term neonates. Operative vaginal delivery was registered in 30%. Temporal was the most common location of subpial hemorrhage (70%), and all patients displayed underlying brain infarction. A characteristic yin-yang pattern was present in 90% of the study cohort, and ingurgitation of medullary veins on susceptibility weighted imaging in 80%. Cerebellar microbleeds were observed in 60% of neonates, both term and preterm. When available, MR angiography and venography were unremarkable. Patients' clinical outcome was variable, with early prematurity not associated to worse outcomes. CONCLUSION: Subpial hemorrhage has a distinctive MR pattern, with underlying parenchymal venous infarction, and can occur in term and preterm neonates. This study results suggest an association between subpial hemorrhage and cerebellar microbleeds but further studies are required to confirm it and better understand the pathophysiology of subpial hemorrhage.
Authors: Christie J Bruno; Lauren A Beslow; Char M Witmer; Arastoo Vossough; Lori C Jordan; Sarah Zelonis; Daniel J Licht; Rebecca N Ichord; Sabrina E Smith Journal: Arch Dis Child Fetal Neonatal Ed Date: 2013-08-30 Impact factor: 5.747
Authors: Sarah Lee; David M Mirsky; Lauren A Beslow; Catherine Amlie-Lefond; Amy R Danehy; Laura Lehman; Nicholas V Stence; Arastoo Vossough; Max Wintermark; Michael J Rivkin Journal: Pediatr Neurol Date: 2017-01-26 Impact factor: 3.372
Authors: Donald W Cain; Andra L Dingman; Jennifer Armstrong; Nicholas V Stence; Alexandria M Jensen; David M Mirsky Journal: Stroke Date: 2019-11-07 Impact factor: 7.914