SONOGRAPHIC LENTICULOSTRIATE VASCULOPATHY IN INFANTS - SOME ASSOCIATIONS AND A HYPOTHESIS

PURPOSE: To describe the causes of infantile lenticulostriate vasculop athy (LSV) as demonstrated by sonography and propose the pathogenesis of these findings. METHODS: Five hundred eighty-six infants were exami ned via echoencephalography because of seizures, psychomotor retardati on, dysmorphism, congenital malformation, microcephaly, macrocephaly, bulging of anterior fontanel, consciousness disturbance, or prematurit y. We directed our attention on the sonographic study to the basal gan glionic and thalamic areas. Twenty-eight of the 586 patients underwent color Doppler studies. RESULTS: In 34 infants with gray-scale neuroso nographic findings of LSV, 16 were associated with various causes that have been reported before. In 8 patients entities not previously asso ciated with LSV were found: neonatal lupus, neonatal hypoglycemia, unc omplicated prematurity, encephalitis, and head injury. In the remainin g 10 cases, a specific cause could not be found. The LSV was found in 16 (40%), 5 (14%), and 13 (3%) patients with perinatal, acquired, and nonspecific causes, respectively. Generally, this is an uncommon findi ng because it was observed in only 34 (5.8%) of the study infants; 24 of these 34 had a documented cause of the vasculopathy. With LSV assoc iated with perinatal causes there was a greater chance of sonographic LSV's developing than with that of acquired causes. CONCLUSIONS: We su ggest that sonographic LSV is a nonspecific marker of a previous insul t to the developing brain, and the special hemodynamics of the fetal b rain plays an important role in its pathogenesis.