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Neonatal Pial Surface Electroporation
Published on: May 7, 2014
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Neonatal subpial hemorrhage: Padua experience and systematic review
Cristina Impieri1, Claudio Ancona2,3, Benedetta Bortolatto1
1Department of Women's and Children's Health, University of Padua, Padua, Italy.
European Journal of Pediatrics
|March 24, 2025
Summary
Subpial hemorrhage (SPH) in neonates is rare, often affecting the temporal lobe and presenting with seizures. Associated parenchymal hemorrhage significantly increases the risk of neurological impairment.
Area of Science:
- Neonatal Neurology
- Pediatric Neurosurgery
- Neurocritical Care
Background:
- Subpial hemorrhage (SPH) is a rare intracranial hemorrhage subtype, primarily affecting term neonates.
- It is frequently linked to cortical-subcortical infarction and predominantly involves the temporal lobe.
Purpose of the Study:
- To describe the epidemiology of neonatal SPH.
- To identify factors associated with adverse outcomes in affected neonates.
Main Methods:
- Retrospective analysis of 10 neonates with SPH (2013-2023).
- Systematic literature review of 163 neonatal SPH cases (PubMed, Scopus, Cochrane, Web of Science up to April 2024).
- Pooled analysis of 173 cases, with a subcohort of 67 for detailed outcome analysis.
Main Results:
- 173 cases analyzed: 92% term/late preterm neonates, 59% male.
- Common presentations: seizures (36%), apnea (36%), encephalopathy (18%).
- Temporal lobe involvement in 60%; 90% had adjacent infarctions. Adverse outcomes: 16% mortality, 53% neurological impairment, 8% epilepsy.
- Low birth weight, seizures, infections, and parenchymal hemorrhage were linked to adverse outcomes.
Conclusions:
- Neonatal SPH is rare, often temporal, and presents with seizures/apneas.
- Neurologic sequelae are common; adjacent parenchymal hemorrhage strongly predicts neurological impairment.
