Neonatal focal temporal lobe or atrial wall haemorrhagic infarction
Paul Govaerta c, K Smetsa, E Matthysa, A Oostrab
a Department
of Neonatology Gent University Hospital
Gent Flanders
Belgium, b Centre for Developmental
Disorders Gent, c Department of Neonatology Sophia
Children's Hospital Dr Molewaterplein 60 3015 GJ Rotterdam The Netherlands
Correspondence to: Dr Paul Govaert Email:govaert{at}alkg.azr.nl
Accepted 26 April
1999
AIMS
To describe two
variants of infarction within the temporal lobe, associated with local
matrix bleeding and mild to moderate intraventricular haemorrhage.
METHODSThe files of
10 neonates, extracted from a sonographic study of 560 very low
birthweight infants conducted between 1993 and 1997, were
retrospectively examined.
RESULTSSeven 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.
CONCLUSIONSThis
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.
Keywords: temporal lobe; matrix haemorrhage; venous infarction; cerebral palsy
© 1999 by Archives of Disease in Childhood
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