Claessens NHP, et al. - Researchers here delineated the clinical and neuroimaging characteristics of cerebral sinovenous thrombosis (CSVT) in neonates undergoing cardiac surgery. As per observations, in comparison to previous reports, CSVT could be more common in neonates undergoing cardiac surgery. In this study, they identified an association of CSVT with higher risk of additional intra-parenchymal brain injury.

Methods

• Researchers included 40 neonates (78% male) requiring neonatal univentricular- or biventricular cardiac repair using cardiopulmonary bypass.
• For detection of CSVT, all underwent preoperative (median postnatal day 7) and postoperative (median postoperative day 7) magnetic resonance imaging of the brain, including venography.
• They compared clinical characteristics between CSVT positive and CSVT negative neonates.

Results

• In this study, CSVT was diagnosed in 11 neonates (28%) postoperatively, with the transverse sinus affected in all, and involvement of multiple sinuses in 10 (91%).
• Preoperatively, 3 cases (8%) indicated signs of thrombosis.
• In CSVT positive, focal infarction of the basal ganglia was markedly more frequent than CSVT negative neonates (P 0.025).
• CSVT positive neonates had longer length to stay at the intensive care unit preoperatively (P 0.001).
• These neonates had lower weight (P 0.024) and lower postmenstrual age (P 0.030) at surgery and prolonged use of a central venous catheter (P 0.023) and a catheter placed in the internal jugular vein more often (P 0.039).
• Between new postoperative CSVT positive and CSVT negative neonates, surgical and postoperative factors were not different.