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 |
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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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