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Archives of Disease in Childhood - Fetal and Neonatal Edition 2004;89:F530; doi:10.1136/adc.2004.049775
Copyright © 2004 BMJ Publishing Group Ltd & Royal College of Paediatrics and Child Health.
Archives of Disease in Childhood Fetal and Neonatal Edition 2004;89:F530
© 2004 Archives of Disease in Childhood Fetal and Neonatal Edition

IMAGES IN NEONATAL MEDICINE

Palpebral ecchymosis and cerebral venous thrombosis in a near term infant

M Fumagalli, L A Ramenghi and F Mosca

NICU, Department of Neonatology, "L Mangiagalli" Clinic, ICP Teaching Hospitals, Via Commenda, 12, 20122 Milan, Italy; monifumagalli@hotmail.com

The first 150 words of the full text of this article appear below.

Cerebral venous thrombosis (CVT) is rarely diagnosed in newborn babies.1 Seizures, haemorrhagic venous infarcts, and, in particular, intraventricular haemorrhage are the most common signs of CVT in term newborns.2 Little is known about the neuroradiological and clinical presenting findings of CVT in preterm babies.

We observed bilateral palpebral ecchymosis in a 35 week gestation preterm baby (fig 1AGo) with major bleeding in the posterior fossa on an ultrasound brain scan (first day of life). Computed tomography imaging on the second day confirmed the haemorrhage and showed an unexpected venous thrombosis ("empty delta sign", a triangle of decreased density caused by the contrast enhanced blood flowing around the clot) of the torcular Herophili (fig 1BGo). The haematoma was surgically drained and an intraventricular reservoir was inserted to treat the acute obstructive hydrocephalus.


 


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