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Hyperdense posterior falx in the neonate
1Department of Diagnostic Radiology and Pediatrics, University of Kentucky Medical Center, 800 Rose Street, Lexington, KY 40536-0084, USA.
Pediatric Radiology
|November 3, 1998
Summary
A hyperdense posterior falx on neonatal head CT scans does not indicate sagittal sinus thrombosis. This finding is likely a false positive due to immature brain development and higher hematocrit in newborns.
Area of Science:
- Neuroradiology
- Neonatal Imaging
Background:
- Hyperdense posterior falx on unenhanced CT scans is a known indicator of sagittal sinus thrombosis in adults.
- The diagnostic significance of this finding in neonates has not been established.
Purpose of the Study:
- To evaluate the association between hyperdense posterior falx/torcula and sagittal sinus thrombosis in newborns.
- To determine the validity of using CT findings to diagnose sagittal sinus thrombosis in neonates.
Main Methods:
- Prospective review of head CT scans in infants within their first week of life.
- Follow-up imaging including ultrasound and MRI for suspected cases.
Main Results:
- Eleven neonatal head CT scans showed a hyperdense posterior falx, suggesting sagittal sinus thrombosis.
- Ten out of eleven infants showed no evidence of venous thrombosis on subsequent ultrasound or MRI.
Conclusions:
- The hyperdense appearance of the posterior falx/torcula in neonatal head CT scans is likely a false positive finding.
- Immature myelination of the neonatal brain and elevated neonatal blood hematocrit contribute to this false impression.