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Coexistance of cerebral sinovenous thrombosis and Dandy Walker malformation in newborn.
Coll Antropol. 2011 Jan; 35 Suppl 1:303-7.CA

Abstract

Cerebral sinovenous thrombosis in neonatal period may cause neurological impairment, epilepsy, and lead to stroke. It is caused primarily by coagulopathy of numerous reasons, occasionally perinatal asphyxia, traumatic delivery and hyperhomocysteinemia. Dandy-Walker malformation is characterized by agenesis or hypoplasia of the cerebellar vermis, cystic dilatation of the fourth ventricle, and enlargement of the posterior fossa. Dandy-Walker malformation, variant, and mega cisterna magna represent a spectrum of developmental anomalies. Insults to developing cerebellar hemispheres and the fourth ventricle are believed to be the cause of malformation. Our patient was born from noncomplicated pregnancy, noncomplicated nontraumatic vaginal delivery at term, excellent Apgar scores, without peculiarities in clinical status. She was brest-fed by the 42nd hour of life when she had rightsided seizures during sleep that repeated for five times in next 24 hours. Brain Ultrasound (US) revealed clot in left lateral ventricle, slight dilatation of left ventricle, both sided periventricular echodensity, ischemia, slight enlargement of forth ventricle and a bit smaller cerebellum. There was no visible flow through left transverse, superior sagittal and straight sinus. Magnetic Resonance (MRI) confirmed the finding and showed thrombosis of left and right transverse venous sinuses and confluence of sinuses. Electroencephalogram (EEG) showed leftsided focal changes. The newborn was treated with phenobarbiton for 8 days and had no convulsions during that period. All coagulation parameters, homocistein, lipoproteins (a) and D-dimers were normal. There were no mutations on FV R506Q, PT 20210A, MTHFR 677C/T. No antiphospholipides were found. Heart US showed no structural anomalies. No other patology or risk factors were present at the time. Before discharge, US showed hydrocephalus. Flow in affected sinuses was visible with color Doppler. MRI showed recanalization of affected sinuses, also hydrocephalus and presentation of Dandy Walker On EEG there was borderline finding. Due to progression of hydrocephalus ventriculo-peritoneal shunt was placed. In age of 1 year EEG was slower for age but without focus. Neurological development was normal for age. The question is whether this child had intrauterine insult and inception of Dandy Walker with further postnatal progress of thrombosis and evolution to full picture of Dandy Walker with hydrocephalus OR thrombosis that led to development of hydrocephalus and Dandy Walker malformation in this child were accidental coexistance.

Authors+Show Affiliations

University of Zagreb, Zagreb University Hospital Center, Neonatal Intensive Care Unit, Department of Obstetrics and Gynecology, Zagreb, Croatia. snjezana1@hi.t-com.hrNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Case Reports
Journal Article

Language

eng

PubMed ID

21648352

Citation

Gverić-Ahmetasević, Snjezana, et al. "Coexistance of Cerebral Sinovenous Thrombosis and Dandy Walker Malformation in Newborn." Collegium Antropologicum, vol. 35 Suppl 1, 2011, pp. 303-7.
Gverić-Ahmetasević S, Colić A, Gverić T, et al. Coexistance of cerebral sinovenous thrombosis and Dandy Walker malformation in newborn. Coll Antropol. 2011;35 Suppl 1:303-7.
Gverić-Ahmetasević, S., Colić, A., Gverić, T., Gasparović, V. E., Pavlisa, G., & Ozretić, D. (2011). Coexistance of cerebral sinovenous thrombosis and Dandy Walker malformation in newborn. Collegium Antropologicum, 35 Suppl 1, 303-7.
Gverić-Ahmetasević S, et al. Coexistance of Cerebral Sinovenous Thrombosis and Dandy Walker Malformation in Newborn. Coll Antropol. 2011;35 Suppl 1:303-7. PubMed PMID: 21648352.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Coexistance of cerebral sinovenous thrombosis and Dandy Walker malformation in newborn. AU - Gverić-Ahmetasević,Snjezana, AU - Colić,Ana, AU - Gverić,Tugomir, AU - Gasparović,Vesna Elvedi, AU - Pavlisa,Goran, AU - Ozretić,David, PY - 2011/6/9/entrez PY - 2011/6/9/pubmed PY - 2011/8/4/medline SP - 303 EP - 7 JF - Collegium antropologicum JO - Coll Antropol VL - 35 Suppl 1 N2 - Cerebral sinovenous thrombosis in neonatal period may cause neurological impairment, epilepsy, and lead to stroke. It is caused primarily by coagulopathy of numerous reasons, occasionally perinatal asphyxia, traumatic delivery and hyperhomocysteinemia. Dandy-Walker malformation is characterized by agenesis or hypoplasia of the cerebellar vermis, cystic dilatation of the fourth ventricle, and enlargement of the posterior fossa. Dandy-Walker malformation, variant, and mega cisterna magna represent a spectrum of developmental anomalies. Insults to developing cerebellar hemispheres and the fourth ventricle are believed to be the cause of malformation. Our patient was born from noncomplicated pregnancy, noncomplicated nontraumatic vaginal delivery at term, excellent Apgar scores, without peculiarities in clinical status. She was brest-fed by the 42nd hour of life when she had rightsided seizures during sleep that repeated for five times in next 24 hours. Brain Ultrasound (US) revealed clot in left lateral ventricle, slight dilatation of left ventricle, both sided periventricular echodensity, ischemia, slight enlargement of forth ventricle and a bit smaller cerebellum. There was no visible flow through left transverse, superior sagittal and straight sinus. Magnetic Resonance (MRI) confirmed the finding and showed thrombosis of left and right transverse venous sinuses and confluence of sinuses. Electroencephalogram (EEG) showed leftsided focal changes. The newborn was treated with phenobarbiton for 8 days and had no convulsions during that period. All coagulation parameters, homocistein, lipoproteins (a) and D-dimers were normal. There were no mutations on FV R506Q, PT 20210A, MTHFR 677C/T. No antiphospholipides were found. Heart US showed no structural anomalies. No other patology or risk factors were present at the time. Before discharge, US showed hydrocephalus. Flow in affected sinuses was visible with color Doppler. MRI showed recanalization of affected sinuses, also hydrocephalus and presentation of Dandy Walker On EEG there was borderline finding. Due to progression of hydrocephalus ventriculo-peritoneal shunt was placed. In age of 1 year EEG was slower for age but without focus. Neurological development was normal for age. The question is whether this child had intrauterine insult and inception of Dandy Walker with further postnatal progress of thrombosis and evolution to full picture of Dandy Walker with hydrocephalus OR thrombosis that led to development of hydrocephalus and Dandy Walker malformation in this child were accidental coexistance. SN - 0350-6134 UR - https://www.unboundmedicine.com/medline/citation/21648352/Coexistance_of_cerebral_sinovenous_thrombosis_and_Dandy_Walker_malformation_in_newborn_ L2 - http://www.diseaseinfosearch.org/result/7087 DB - PRIME DP - Unbound Medicine ER -