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An Important Finding of White Matter Injury in Late Preterm Infant: Deep Medullary Vein Involvement

Dan Chen1, Jing Sun1, Qiuyu Li1

  • 1Department of Pediatrics, Shengjing Hospital of China Medical University, Shenyang, China.

Frontiers in Pediatrics
|January 4, 2021
PubMed

Insights

Abnormal deep medullary veins (DMVs) are linked to severe white matter injury (WMI) in late preterm infants. These infants show higher risks of maternal diabetes, seizures, and specific brain injuries, including thalamic damage.

Area of Science:

  • Neonatal neurology
  • Pediatric radiology
  • Neuroimaging

Background:

  • Severe white matter injury (WMI) is a significant concern in late preterm infants.
  • Deep medullary veins (DMVs) play a crucial role in brain development and venous drainage.
  • Abnormalities in DMVs may be associated with adverse neurological outcomes.

Purpose of the Study:

  • To identify high-risk factors and magnetic resonance imaging (MRI) features in late preterm infants with severe WMI and abnormal DMVs.
  • To compare MRI characteristics and risk factors between infants with and without abnormal DMVs.

Main Methods:

  • Retrospective analysis of 2032 late preterm infants hospitalized between 2009 and 2018.
  • Inclusion criteria: severe WMI diagnosed via MRI.
  • Comparison of infants with abnormal DMVs versus those with normal DMVs regarding risk factors and MRI findings.

Main Results:

  • 71 infants (3.5%) had severe WMI; 15 (21.1%) of these had abnormal DMVs.
  • Maternal diabetes and neonatal convulsions were more frequent in infants with abnormal DMVs (P < 0.05).
  • Higher incidence of grade IV WMI, periventricular cysts, thalamic injury, cerebral venous sinus thrombus, and germinal matrix/intraventricular hemorrhage in infants with abnormal DMVs (P < 0.01).

Conclusions:

  • Congestion or thrombosis of DMVs may cause severe WMI, particularly periventricular leukomalacia-like WMI, in late preterm infants.
  • WMI associated with abnormal DMVs increases the likelihood of thalamic injury.
  • Abnormal DMVs are a significant imaging marker to consider in preterm infants with WMI.

Keywords:
PVLdeep medullary veinhigh risk factorlate preterm infantwhite matter injury

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