NEONATAL CENTRAL-NERVOUS-SYSTEM VASCULAR DISORDERS

Central nervous system vascular disorders in the neonate comprise stru ctural anomalies or malformations of arteries and veins and physiologi c alterations of cerebral blood flow, which can mimic structural vascu lar disease. Clinical, imaging, and transcatheter therapeutic aspects of neonatal cerebral vascular malformations are described. Symptomatic high-flow vascular malformations characteristically present with card iac failure and associated systemic problems in the neonate, whereas i nfants typically present with macrocephaly and hydrocephalus and older children with hemorrhage, developmental delay, or focal deficits. Neo natal cerebral hemorrhage is typically primary or associated with imma turity, parturitional trauma, or coagulopathy. Likewise, cerebral isch emic lesions are more likely secondary to hypoxic, ischemic events tha n to thromboembolic or structural cerebrovascular occlusive disease. T he role of the current noninvasive imaging modalities in each of these clinical problems is reviewed and illustrated.