Clinical and neuroimaging characteristics of cerebral sinovenous thrombosis in neonates undergoing cardiac surgery

Autor: Felix Haas, Floris Groenendaal, Nicolaas J. G. Jansen, Antonius N. J. Schouten, Rutger A.J. Nievelstein, Esther de Wit, Manon J.N.L. Benders, Selma O. Algra, Alexander A Wilbrink, Linda S. de Vries, Nathalie H.P. Claessens
Rok vydání: 2018
Předmět:
Heart Defects
Congenital
Male
Pulmonary and Respiratory Medicine
medicine.medical_specialty
Time Factors
Heart disease
medicine.medical_treatment
Venography
Infarction
law.invention
Sinus Thrombosis
Intracranial
03 medical and health sciences
0302 clinical medicine
Predictive Value of Tests
Risk Factors
law
030225 pediatrics
Cardiopulmonary bypass
Humans
Medicine
Cardiac Surgical Procedures
Internal jugular vein
Retrospective Studies
Congenital heart disease
Cardiopulmonary Bypass
medicine.diagnostic_test
business.industry
Age Factors
Infant
Newborn
Brain
Phlebography
Newborn
medicine.disease
Thrombosis
Cerebral Angiography
Cardiac surgery
Treatment Outcome
Anesthesia
Female
Surgery
Cardiology and Cardiovascular Medicine
business
Magnetic Resonance Angiography
030217 neurology & neurosurgery
Central venous catheter
MRI
Zdroj: Journal of Thoracic and Cardiovascular Surgery, 155(3), 1150. Mosby Inc.
ISSN: 0022-5223
Popis: 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.
Databáze: OpenAIRE
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