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Palpebral ecchymosis and cerebral venous thrombosis in a near term infant

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 1A) 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 1B). The haematoma was surgically drained and an intraventricular reservoir was inserted to treat the acute obstructive hydrocephalus.

View larger version (84K): [in this window] [in a new window]   Figure 1  (A) Bilateral palpebral ecchymosis. (B) Computed tomography scan showing venous thrombosis ("empty delta sign" of torcular Herophili), . . . [Full text of this article]