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Updated: Jun 12, 2026
10:02
State of the Art Cranial Ultrasound Imaging in Neonates
Published on: February 2, 2015
24.3K
Neuroimaging of Neonatal Stroke: Venous Focus
Lillian M Lai1, Takashi Shawn Sato1, Sedat Giray Kandemirli1
1From the Department of Radiology, University of Iowa Stead Family Children's Hospital, 200 Hawkins Dr, Iowa City, IA 52242-1077.
Summary
Neonatal venous infarcts are often missed but can be identified by characteristic patterns on imaging. Understanding cerebral venous anatomy is key for diagnosis and timely anticoagulation treatment, even with hemorrhage.
Area of Science:
- Neuroradiology
- Neonatal Neurology
- Pediatric Stroke
Background:
- Perinatal venous infarcts are underrecognized in neonates.
- Neonates are susceptible due to hypercoagulability, dural sinus compressibility, and immature venous drainage.
- Pediatric cerebral sinovenous thrombosis (CSVT) has a high incidence in the neonatal period (43%).
Purpose of the Study:
- To highlight the clinical and imaging underrecognition of perinatal venous infarcts.
- To educate on recognizing characteristic venous infarct patterns based on venous anatomy.
- To emphasize the importance of considering anticoagulation for CSVT in neonates.
Main Methods:
- Review of imaging findings and clinical presentations of neonatal venous infarcts.
- Correlation of infarct patterns with specific cerebral venous drainage pathways.
- Discussion of risk factors and diagnostic challenges in the neonatal population.
Main Results:
- Venous infarcts present as ischemia or hemorrhage independent of arterial territories.
- Specific hemorrhage patterns suggest thrombosis in the internal cerebral vein (thalamocaudate), basal vein of Rosenthal (striato-hippocampal), or choroid plexus veins.
- Deep medullary congestion/thrombosis relates to impaired venous drainage, often secondary to germinal matrix hemorrhage or impeded deep venous flow.
Conclusions:
- Recognizing characteristic venous infarct patterns aids diagnosis.
- Knowledge of venous anatomy is crucial for radiologists.
- Anticoagulation is the recommended treatment for CSVT, even with coexisting intracranial hemorrhage.
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