Neonatal lenticulostriate vasculopathy: further characterisation

Abstract

Background: Lenticulostriate vasculopathy (LSV) is sometimes detected on routine brain ultrasonography in neonates, and is often associated with various perinatal and neonatal abnormalities. However, most reports on LSV are retrospective with no controls.

Objectives: To compare the perinatal and neonatal clinical characteristics of neonates with LSV with matched controls and to summarise all published reports of LSV.

Design: A prospective study that summarises the clinical, laboratory, and neurosonographic data of neonates with LSV.

Methods: Of 1184 neonates admitted to the neonatal intensive care unit (NICU) during a three year period, 857 had a routine head ultrasound examination. Twenty one had LSV, and were compared with 42 matched controls with regard to gestational, perinatal, neonatal, laboratory, and neurosonographic characteristics.

Results: LSV was detected in 21 of the 857 (2.45%) neonates. It was bilateral in 10 of the 21 cases and located in the thalamus (n = 14) and basal ganglia (n = 7). Infants with LSV were not significantly different from matched controls in most tested variables. However, compared with the control group, the LSV group included significantly more multiple births and more disturbances in amniotic fluid volume, but less meconial amniotic fluid. In addition, the patients with LSV required fewer blood transfusions and less phototherapy.

Conclusions: Except for more multiple births, neonates with LSV did not display more adverse findings than their matched controls.

Figure 1

Ultrasound through anterior fontanelle showing branching echogenic linear structures in the thalamus (arrows). (A) Coronal scan; (B) sagittal scan.

Figure 2

Sagittal colour Doppler image showing the vascular nature of these thalamic echogenicities (arrows).