Case Study
Periventricular haemorrhagic infarct in a preterm neonate

https://doi.org/10.1053/ejpn.1999.0175Get rights and content

Abstract

Magnetic resonance imaging (MRI) was performed on an infant born at 28 weeks gestational age who suffered a sudden episode of bradycardia and desaturation on the 3rd day of life. Imaging demonstrated bilateral germinal layer haemorrhage and intraventricular haemorrhage, with parenchymal involvement in a fan-shaped pattern in the periventricular white matter on the left. These appearances are consistent with a combination of intravascular thrombi and perivascular haemorrhage along the course of the medullary veins. We believe that this is the first report of the MRI appearance of an acute periventricular haemorrhagic infarct associated with a germinal layer haemorrhage/intraventricular haemorrhage in a preterm neonate.

References (0)

Cited by (31)

  • Fetal and neonatal neuroimaging

    2019, Handbook of Clinical Neurology
    Citation Excerpt :

    Doppler ultrasound has shown reduced blood flow velocity in the terminal vein on the affected side (Taylor, 1995), suggesting impaired venous drainage. The periventricular hemorrhage is shown as a fan-shaped structure, due to obstructed medullary veins, of low signal intensity on T2-weighted imaging (Haddad et al., 1992; Counsell et al., 1999). Parenchymal hemorrhagic infarction results in interruption of projection and association fibers and oligodendroglial damage, which disrupts myelination.

  • Pathogenesis of Germinal Matrix Hemorrhage

    2017, Fetal and Neonatal Physiology, 2-Volume Set
  • Intraventricular Hemorrhage in the Neonate

    2011, Fetal and Neonatal Physiology E-Book, Fourth Edition
  • Intracranial Hemorrhage in the Preterm Infant: Understanding It, Preventing It

    2009, Clinics in Perinatology
    Citation Excerpt :

    Almost a decade later, Taylor89 found decreased flow velocity and displacement of the ipsilateral terminal vein using Doppler in living infants with PVHI (Fig. 2). Perivascular hemorrhage and presumed intravascular thrombi along the medullary veins were subsequently demonstrated in an MRI study by Counsell and colleagues,26 confirming original pathologic studies that suggested intravascular thrombi in the medullary veins.88 Govaert and colleagues90 and Dudink and colleagues91 suggested that the pathogenesis of temporal and parietotemporal (atrial) distribution PVHIs may not stem from terminal vein involvement but rather are secondary to involvement of the inferior ventricular and lateral atrial veins, respectively.

  • MRI of the newborn brain

    2008, Paediatrics and Child Health
    Citation Excerpt :

    Preterm infants may have lesions within the cerebral parenchymal such as periventricular leucomalacia, haemorrhagic parenchymal infarction or intraventricular haemorrhage with or without dilatation. Haemorrhagic infarction is seen as a fan-shaped area of low signal intensity surrounded by relative high signal intensity on T2-weighted imaging (Figure 11a).26 This area then undergoes cystic degeneration to form a porencephalic cyst by term age.27

View all citing articles on Scopus
f1

Correspondence: Ms S J Counsell, MRI Unit, Hammersmith Hospital, DuCane Road, London W12 0HS, UK

View full text