Skip to main content
PMC home page
Archives of Disease in Childhood. Fetal and Neonatal Edition logoLink to Archives of Disease in Childhood. Fetal and Neonatal Edition
. 1999 Nov;81(3):F211–F216. doi: 10.1136/fn.81.3.f211

Neonatal focal temporal lobe or atrial wall haemorrhagic infarction

P Govaert, K Smets, E Matthys, A Oostra
PMCID: PMC1721019  PMID: 10525027

Abstract

AIMS— To describe two variants of infarction within the temporal lobe, associated with local matrix bleeding and mild to moderate intraventricular haemorrhage.
METHODS—The files of 10 neonates, extracted from a sonographic study of 560 very low birthweight infants conducted between 1993 and 1997, were retrospectively examined.
RESULTS—Seven lesions were located in the middle to posterior area of the temporal lobe, three others faced the atrium. All except two of those with a temporal site were VLBW infants with hyaline membrane disease. Except for one fatal case, intraventricular bleeding was mild to moderate. Computed tomograms or magnetic resonance imaging were used to illustrate the haemorrhagic nature of three lesions. Survivors of this so far undescribed entity who were followed up for more than 18 months did not have a uniform type of cerebral palsy but some scored in the low normal range on the Bayley Mental Development Index. One girl developed temporal lobe epilepsy.
CONCLUSIONS—This pattern of injury seems to be one of venous infarction associated with temporal or para-atrial matrix haemorrhage. The temporal site fits the picture of venous infarction within the area drained by the inferior ventricular vein. A less constant lateral atrial vein, either draining into the basal or internal cerebral vein, is probably involved in the para-atrial lesion. Sonography may be the only practical tool currently available for detection in life.



Full Text

The Full Text of this article is available as a PDF (212.7 KB).

Selected References

These references are in PubMed. This may not be the complete list of references from this article.

  1. Archer L. N., Evans D. H., Paton J. Y., Levene M. I. Controlled hypercapnia and neonatal cerebral artery Doppler ultrasound waveforms. Pediatr Res. 1986 Mar;20(3):218–221. doi: 10.1203/00006450-198603000-00004. [DOI] [PubMed] [Google Scholar]
  2. BANKER B. Q., LARROCHE J. C. Periventricular leukomalacia of infancy. A form of neonatal anoxic encephalopathy. Arch Neurol. 1962 Nov;7:386–410. doi: 10.1001/archneur.1962.04210050022004. [DOI] [PubMed] [Google Scholar]
  3. Billard C., Dulac O., Diebler C. Ramollissement cérébral ischémique du nouveau-né. Une étiilogie possible des états de mal convulsifs néonatals. Arch Fr Pediatr. 1982 Nov;39(9):677–683. [PubMed] [Google Scholar]
  4. Blackman J. A., McGuinness G. A., Bale J. F., Jr, Smith W. L., Jr Large postnatally acquired porencephalic cysts: unexpected developmental outcomes. J Child Neurol. 1991 Jan;6(1):58–64. doi: 10.1177/088307389100600113. [DOI] [PubMed] [Google Scholar]
  5. Clancy R., Malin S., Laraque D., Baumgart S., Younkin D. Focal motor seizures heralding stroke in full-term neonates. Am J Dis Child. 1985 Jun;139(6):601–606. doi: 10.1001/archpedi.1985.02140080071035. [DOI] [PubMed] [Google Scholar]
  6. Cleveland R. H., Herman T. E., Oot R. F., Kushner D. C. The evolution of neonatal herpes encephalitis as demonstrated by cranial ultrasound with CT correlation. Am J Perinatol. 1987 Jul;4(3):215–219. doi: 10.1055/s-2007-999776. [DOI] [PubMed] [Google Scholar]
  7. De Vries L. S., Regev R., Connell J. A., Bydder G. M., Dubowitz L. M. Localized cerebral infarction in the premature infant: an ultrasound diagnosis correlated with computed tomography and magnetic resonance imaging. Pediatrics. 1988 Jan;81(1):36–40. [PubMed] [Google Scholar]
  8. Fujimoto S., Yokochi K., Togari H., Nishimura Y., Inukai K., Futamura M., Sobajima H., Suzuki S., Wada Y. Neonatal cerebral infarction: symptoms, CT findings and prognosis. Brain Dev. 1992 Jan;14(1):48–52. doi: 10.1016/s0387-7604(12)80279-8. [DOI] [PubMed] [Google Scholar]
  9. Govaert P., Achten E., Vanhaesebrouck P., De Praeter C., Van Damme J. Deep cerebral venous thrombosis in thalamo-ventricular hemorrhage of the term newborn. Pediatr Radiol. 1992;22(2):123–127. doi: 10.1007/BF02011312. [DOI] [PubMed] [Google Scholar]
  10. Govaert P., Bridger J., Wigglesworth J. Nature of the brain lesion in fetal allo-immune thrombocytopenia. Dev Med Child Neurol. 1995 Jun;37(6):485–495. doi: 10.1111/j.1469-8749.1995.tb12036.x. [DOI] [PubMed] [Google Scholar]
  11. Govaert P., Leroy J., Caemaert J., Wood B. P. Radiological case of the month. Extensive neonatal subarachnoid hematoma. Am J Dis Child. 1992 May;146(5):635–636. doi: 10.1001/archpedi.1992.02160170115027. [DOI] [PubMed] [Google Scholar]
  12. Govaert P., Vanhaesebrouck P., de Praeter C. Traumatic neonatal intracranial bleeding and stroke. Arch Dis Child. 1992 Jul;67(7 Spec No):840–845. doi: 10.1136/adc.67.7_spec_no.840. [DOI] [PMC free article] [PubMed] [Google Scholar]
  13. Guzzetta F., Shackelford G. D., Volpe S., Perlman J. M., Volpe J. J. Periventricular intraparenchymal echodensities in the premature newborn: critical determinant of neurologic outcome. Pediatrics. 1986 Dec;78(6):995–1006. [PubMed] [Google Scholar]
  14. Levy S. R., Abroms I. F., Marshall P. C., Rosquete E. E. Seizures and cerebral infarction in the full-term newborn. Ann Neurol. 1985 Apr;17(4):366–370. doi: 10.1002/ana.410170411. [DOI] [PubMed] [Google Scholar]
  15. Mannino F. L., Trauner D. A. Stroke in neonates. J Pediatr. 1983 Apr;102(4):605–610. doi: 10.1016/s0022-3476(83)80200-5. [DOI] [PubMed] [Google Scholar]
  16. Marín-Padilla M. Developmental neuropathology and impact of perinatal brain damage. I: Hemorrhagic lesions of neocortex. J Neuropathol Exp Neurol. 1996 Jul;55(7):758–773. doi: 10.1097/00005072-199607000-00002. [DOI] [PubMed] [Google Scholar]
  17. Niijima S., Shortland D. B., Levene M. I., Evans D. H. Transient hyperoxia and cerebral blood flow velocity in infants born prematurely and at full term. Arch Dis Child. 1988 Oct;63(10 Spec No):1126–1130. doi: 10.1136/adc.63.10_spec_no.1126. [DOI] [PMC free article] [PubMed] [Google Scholar]
  18. PADGET D. H. The cranial venous system in man in reference to development, adult configuration, and relation to the arteries. Am J Anat. 1956 May;98(3):307–355. doi: 10.1002/aja.1000980302. [DOI] [PubMed] [Google Scholar]
  19. Perlman J. M., Rollins N., Burns D., Risser R. Relationship between periventricular intraparenchymal echodensities and germinal matrix-intraventricular hemorrhage in the very low birth weight neonate. Pediatrics. 1993 Feb;91(2):474–480. [PubMed] [Google Scholar]
  20. Perlman J. M., Volpe J. J. Are venous circulatory abnormalities important in the pathogenesis of hemorrhagic and/or ischemic cerebral injury? Pediatrics. 1987 Nov;80(5):705–711. [PubMed] [Google Scholar]
  21. Rademaker K. J., Groenendaal F., Jansen G. H., Eken P., de Vries L. S. Unilateral haemorrhagic parenchymal lesions in the preterm infant: shape, site and prognosis. Acta Paediatr. 1994 Jun;83(6):602–608. doi: 10.1111/j.1651-2227.1994.tb13089.x. [DOI] [PubMed] [Google Scholar]
  22. Remillard G. M., Ethier R., Andermann F. Temporal lobe epilepsy and perinatal occlusion of the posterior cerebral artery. A syndrome analogous to infantile hemiplegia and a demonstrable etiology in some patients with temporal lobe epilepsy. Neurology. 1974 Nov;24(11):1001–1009. doi: 10.1212/wnl.24.11.1001. [DOI] [PubMed] [Google Scholar]
  23. Romodanov A. P., Brodsky YuS Subdural hematomas in the newborn. Surgical treatment and results. Surg Neurol. 1987 Oct;28(4):253–258. doi: 10.1016/0090-3019(87)90302-8. [DOI] [PubMed] [Google Scholar]
  24. Taylor G. A. Intracranial venous system in the newborn: evaluation of normal anatomy and flow characteristics with color Doppler US. Radiology. 1992 May;183(2):449–452. doi: 10.1148/radiology.183.2.1561348. [DOI] [PubMed] [Google Scholar]
  25. Towbin A. Central nervous system damage in the human fetus and newborn infant. Mechanical and hypoxic injury incurred in the fetal-neonatal period. Am J Dis Child. 1970 Jun;119(6):529–542. doi: 10.1001/archpedi.1970.02100050531015. [DOI] [PubMed] [Google Scholar]
  26. Vargha-Khadem F., O'Gorman A. M., Watters G. V. Aphasia and handedness in relation to hemispheric side, age at injury and severity of cerebral lesion during childhood. Brain. 1985 Sep;108(Pt 3):677–696. doi: 10.1093/brain/108.3.677. [DOI] [PubMed] [Google Scholar]
  27. Volpe J. J., Herscovitch P., Perlman J. M., Kreusser K. L., Raichle M. E. Positron emission tomography in the asphyxiated term newborn: parasagittal impairment of cerebral blood flow. Ann Neurol. 1985 Mar;17(3):287–296. doi: 10.1002/ana.410170312. [DOI] [PubMed] [Google Scholar]
  28. Winkler P., Helmke K. Duplex-scanning of the deep venous drainage in the evaluation of blood flow velocity of the cerebral vascular system in infants. Pediatr Radiol. 1989;19(2):79–90. doi: 10.1007/BF02387891. [DOI] [PubMed] [Google Scholar]
  29. Wulfeck B. B., Trauner D. A., Tallal P. A. Neurologic, cognitive, and linguistic features of infants after early stroke. Pediatr Neurol. 1991 Jul-Aug;7(4):266–269. doi: 10.1016/0887-8994(91)90043-k. [DOI] [PubMed] [Google Scholar]
  30. de Vries L. S., Eken P., Beek E., Groenendaal F., Meiners L. C. The posterior fontanelle: a neglected acoustic window. Neuropediatrics. 1996 Apr;27(2):101–104. doi: 10.1055/s-2007-973757. [DOI] [PubMed] [Google Scholar]
  31. deLemos R. A., Tomasovic J. J. Effects of positive pressure ventilation on cerebral blood flow in the newborn infant. Clin Perinatol. 1978 Sep;5(2):395–409. [PubMed] [Google Scholar]
  32. von Cramon D. Y., Hebel N., Schuri U. Verbal memory and learning in unilateral posterior cerebral infarction. A report on 30 cases. Brain. 1988 Oct;111(Pt 5):1061–1077. doi: 10.1093/brain/111.5.1061. [DOI] [PubMed] [Google Scholar]

Articles from Archives of Disease in Childhood. Fetal and Neonatal Edition are provided here courtesy of BMJ Publishing Group

RESOURCES