Lenticulostriate vasculopathy in very preterm infants

Lara M Leijser ^1*, Sylke J Steggerda ¹, Francisca T de Bruïne ², Anke van Zuijlen ¹, Andrea van Steenis ¹, Frans J Walther ¹ and Gerda van Wezel-Meijler ¹

¹ Department of Pediatrics, Division of Neonatology, Leiden University Medical Center, Leiden, Netherlands
² Department of Radiology, Leiden University Medical Center, Leiden, Netherlands

^* To whom correspondence should be addressed. E-mail: l.m.leijser{at}lumc.nl.

Accepted 8 May 2009

Abstract

Objective: To assess for lenticulostriate vasculopathy (LSV) on cranial ultrasound (cUS) scans of very preterm infants: incidence and etiology, evolution during neonatal period, association with clinical parameters, and MRI-equivalent.

Design: Prospective study.

Setting: Tertiary neonatal referral center.

Patients: Very preterm infants (<32 weeks) underwent sequential cUS throughout the neonatal period and MRI around term age. cUS were evaluated for LSV and other changes, and MRI for changes in signal and myelination in deep grey matter. LSV was divided in early-onset (7 postnatal days) and late-onset (>7 postnatal days). Perinatal clinical parameters were collected for all infants and compared between groups.

Results: In 22/111 (20%) infants LSV was detected; early-onset in 5 and late-onset in 17. LSV mostly presented some weeks after birth and persisted for several months. There were no associations between LSV and other changes on cUS or deep grey matter changes on MRI. Infants with late-onset LSV were younger and smaller at birth than infants with early-onset LSV. Postmenstrual age at first detection was comparable for both LSV groups. There were no associations between LSV and perinatal clinical parameters, but infants with LSV had less episodes of hypotension than infants without LSV.

Conclusions: LSV is a frequent finding on cUS in very preterm infants, but does not show on MRI. The postmenstrual age, rather than gestational and postnatal age, seems important in LSV development. LSV is not associated with clinical parameters. When encountered in otherwise healthy preterm infants, LSV is probably a benign temporary phenomenon.