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Cerebral Sinovenous Thrombosis in the Asphyxiated Cooled Infants: A Prospective Observational Study.
- Source :
-
Pediatric neurology [Pediatr Neurol] 2017 Jan; Vol. 66, pp. 63-68. Date of Electronic Publication: 2016 Oct 06. - Publication Year :
- 2017
-
Abstract
- Background: Cerebral sinovenous thrombosis is unusual in the asphyxiated cooled infants, but reliable data regarding the incidence of this comorbidity are lacking. We assessed the incidence of sinovenous thrombosis in a population of asphyxiated cooled infants by performing routine brain magnetic resonance venography.<br />Methods: All asphyxiated infants who underwent therapeutic cooling at our institution completed brain magnetic resonance venography after rewarming. Assessing the incidence of cerebral sinovenous thrombosis was the primary goal. Secondary analyses included group comparisons for laboratory tests and monitored parameters, relationship between variables, logistic regression models, and receiver operating characteristic curve for cerebral sinovenous thrombosis prediction.<br />Results: Cerebral sinovenous thrombosis was detected in 10 of 37 infants (27%), most commonly affecting the superior sagittal sinus (eight of ten). These infants manifested higher blanket (P < 0.001) and lower esophageal temperatures (P = 0.006), lower platelet counts (P = 0.045), and received more red blood cell transfusions (P = 0.038) than the cooled infants without thrombosis. Blanket temperature was independently associated with cerebral sinovenous thrombosis (P = 0.049), and 32°C/hour was the optimal cutoff value to predict the event (sensitivity, 90%; specificity, 88.5%).<br />Conclusions: High incidence or cerebral sinovenous thrombosis in neonates treated with therapeutic hypothermia suggests that magnetic resonance venography may be reasonable in many of these children. High blanket temperature may be one variable that helps identify patients at higher risk.<br /> (Copyright © 2016 Elsevier Inc. All rights reserved.)
- Subjects :
- Area Under Curve
Asphyxia Neonatorum diagnostic imaging
Asphyxia Neonatorum physiopathology
Brain diagnostic imaging
Comorbidity
Female
Follow-Up Studies
Humans
Incidence
Infant, Newborn
Logistic Models
Magnetic Resonance Imaging
Male
Phlebography
Prospective Studies
ROC Curve
Risk
Sinus Thrombosis, Intracranial diagnostic imaging
Sinus Thrombosis, Intracranial physiopathology
Temperature
Vascular Patency
Asphyxia Neonatorum epidemiology
Asphyxia Neonatorum therapy
Hypothermia, Induced adverse effects
Hypothermia, Induced methods
Sinus Thrombosis, Intracranial epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1873-5150
- Volume :
- 66
- Database :
- MEDLINE
- Journal :
- Pediatric neurology
- Publication Type :
- Academic Journal
- Accession number :
- 27823842
- Full Text :
- https://doi.org/10.1016/j.pediatrneurol.2016.09.006