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State of the Art Cranial Ultrasound Imaging in Neonates
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Developmental venous anomaly in the newborn brain.

S Horsch1, P Govaert, F M Cowan

  • 1Department of Neonatology, Erasmus MC-Sophia Children's Hospital, Rotterdam, The Netherlands, s.horsch@gmx.de.

Neuroradiology
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Summary

Neonatal diagnosis of cerebral developmental venous anomaly (DVA) is possible with cranial ultrasound and MRI. These vascular malformations are often incidental findings that can change during infancy.

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Area of Science:

  • Neonatal neurology
  • Pediatric neuroradiology
  • Vascular malformations

Background:

  • Cerebral developmental venous anomaly (DVA) is a common adult brain vascular malformation, but its neonatal presentation is poorly understood.
  • DVAs are typically considered congenital, yet their occurrence and characteristics in newborns remain largely uninvestigated.
  • This study presents the first cohort investigating DVAs diagnosed in the neonatal period.

Purpose of the Study:

  • To report the first cohort study of 14 neonates diagnosed with cerebral developmental venous anomaly (DVA).
  • To describe the diagnostic utility of cranial ultrasound (cUS) and magnetic resonance imaging (MRI) in neonates with DVA.
  • To characterize the imaging appearances and potential dynamic changes of neonatal DVAs.

Main Methods:

  • A retrospective review of 14 infants (seven preterm) diagnosed with DVA neonatally.
  • Diagnosis was confirmed using cranial ultrasound (cUS) and magnetic resonance imaging (MRI).
  • Data were collected from three tertiary neonatal units over a 14-year period.

Main Results:

  • Developmental venous anomaly (DVA) was detected by cUS in 6 infants and MRI in 8.
  • cUS revealed a focal area of increased echogenicity, often near the lateral ventricle and in the frontal lobe.
  • Doppler ultrasound showed varied blood flow patterns, and MRI appearances were similar to adults; serial imaging indicated potential dynamic changes in some DVAs.

Conclusions:

  • Neonatal diagnosis of DVA is feasible with careful cUS and MRI.
  • DVAs in neonates are typically incidental findings with diverse imaging presentations.
  • Serial imaging suggests that some DVAs exhibit dynamic changes in the neonatal period and early infancy, potentially explaining diagnostic rarity at this age.