Pathophysiology and Sonographic Correlates of Neonatal Brain Injury

  • G. A. Taylor
Conference paper
Part of the Syllabus book series (SYLLABUS)


In the last few years there have been significant advances in the understanding of the mechanisms responsible for neonatal brain injury. At the same time, ultrasound techniques have continued to improve at a dramatic pace allowing us to identify flow in sub-millimeter arteries and in the main venous drainage pathways of the brain. This presentation will review some of the new findings related to the pathophysiology of cerebrovascular injury in the newborn and how they relate to cranial sonographic findings.


Premature Infant Hypoxic Ischemia Double Outlet Right Ventricle Germinal Matrix Intracranial Compliance 
These keywords were added by machine and not by the authors. This process is experimental and the keywords may be updated as the learning algorithm improves.


Unable to display preview. Download preview PDF.

Unable to display preview. Download preview PDF.


  1. 1.
    Volpe JJ (1995) Intracranial hemorrhage: germinal matrixintraventricular hemorrhage of the premature infant. In: Volpe JJ (ed) Neurology of the Newborn, 3rd edn. WB Saunders, Philadelphia, pp 403–466Google Scholar
  2. 2.
    McDonald JW, Johnston MV (1993) Excitatory amino acid neurotoxicity in the developing brain. NIDA Res Monogr 133: 185–205PubMedGoogle Scholar
  3. 3.
    Johnston MV, Trescher WH, Taylor GA (1995) Hypoxic and ischemic central nervous system disorders in infants and children. Adv Pediatr 42: 1–45PubMedGoogle Scholar
  4. 4.
    Taylor GA, Trescher WH, Johnston MV, Traystman RJ (1995) Experimental neuronal injury in the newborn lamb: a comparison of NMDA receptor blockade and nitric oxide synthesis inhibition on lesion size and cerebral hyperemia. Pediatr Res 38: 644–651PubMedCrossRefGoogle Scholar
  5. 5.
    McDonald JW, Silverstein FS, Johnston MV(1988) Neurotoxicity of N-methyl-d-aspartate is markedly enhanced in developing rat central nervous system. Brain Res 459: 200–203Google Scholar
  6. 6.
    Perlman JM, Volpe JJ (1987) Are venous circulatory abnormalities important in the pathogenesis of hemorrhagic and/or ischemic cerebral injury? Pediatrics 80: 705–711PubMedGoogle Scholar
  7. 7.
    Dean LM, Taylor GA (1995) The intracranial venous system in infants: normal and abnormal findings on duplex and color Doppler sonography. AJR 164: 151–156PubMedGoogle Scholar
  8. 8.
    Ghazi-Birry HS, Brown WR, Moody DM, Challa V R, Block SM, Reboussin DM (1997) Venous origin of germinal matrix hemorrhage in VLBW preterm neonates and vascular characteristics of the human germinal matrix. Am J Neuroradiol 184: 219–229Google Scholar
  9. 9.
    Gould SJ, Howard S, Hope PL, Reynolds FOR (1987) Periventricular intraparenchymal cerebral hemorrhage in preterm infants: the role of venous infarction. J Pathol 151: 197–202PubMedCrossRefGoogle Scholar
  10. 10.
    Taylor GA (1995) Effect of germinal matrix hemorrhage on terminal vein position and patency. Pediatr Radiol 25: S37 - S40PubMedCrossRefGoogle Scholar
  11. 11.
    Volpe JJ (1996) Subplate neurons, missing link in brain injury of the premature brain? Pediatrics 1: 112–113Google Scholar
  12. 12.
    De Vries LS, Larroche J-C, Levene MI (1988) Intracranial sequelae. In: Levene MI, Bennett MJ, Punt J (eds) Fetal and neonatal neurology and neurosurgery. Churchill-Livingstone, New York, pp 346–353Google Scholar
  13. 13.
    Gurtner P, Bass T, Gudeman SK, et al. (1992) Surgical management of posthemorrhagic hydrocephalus in 22 low-birthweight infants. Nery Syst 8: 198–202CrossRefGoogle Scholar
  14. 14.
    Hall TR, Choi A, Schellinger D, et al. (1992) Isolation of the fourth ventricle causing transtentorial herniation: neurosonographic findings in premature infants. AJR 159: 811–815PubMedGoogle Scholar
  15. 15.
    Rudas G, Almâssy Z, Papp B, Varga E, Méder Ü, Taylor GA (1998) Echodense spinal subarachnoid space in neonates with progressive ventricular dilatation: a marker of noncommunicating hydrocephalus. AJR 171: 1119–1121PubMedGoogle Scholar
  16. 16.
    Chadduck WM, Seibert JJ (1989) Intracranial duplex Doppler; practical uses in pediatric neurology and neurosurgery. J Child Neurol 4: S77 - S86PubMedGoogle Scholar
  17. 17.
    Lui K, Hellman J, Sprigg A, et al. (1990) Cerebral blood-flow velocity patterns in post-hemorrhagic ventricular dilatation. Childs Nery Syst 6: 250–253CrossRefGoogle Scholar
  18. 18.
    Seibert JJ, McCowan TC, Chadduck WM, et al. (1989) Duplex pulsed Doppler US versus intracranial pressure in the neonate: clinical and experimental studies. Radiology 171: 155–159PubMedGoogle Scholar
  19. 19.
    Taylor GA, Short LB, Walker LK, et al. (1990) Intracranial blood flow: quantification with duplex Doppler and color Doppler flow US. Radiology 176: 231–236PubMedGoogle Scholar
  20. 20.
    Volpe JJ (1995) Intracranial hemorrhage: germinal matrix-intraventricular hemorrhage of the premature infant. In: Volpe JJ (ed) Neurology of the newborn, 3rd edn. WB Saunders, Philadelphia, pp 403–463Google Scholar
  21. 21.
    Taylor GA, Phillips MD, Ichord RN, et al. (1994) Doppler evaluation of intracranial compliance in infants. Radiology 191: 787–791PubMedGoogle Scholar
  22. 22.
    Goh D, Minns RA, Hendry GMA, et al. (1992) Cerebrovascular resistive index assessed by duplex Doppler sonography and its relationship to intracranial pressure in infantile hydrocephalus. Pediatr Radiol 22: 246–250PubMedCrossRefGoogle Scholar
  23. 23.
    Goh D, Minns RA, Pye SD, et al. (1991) Cerebral blood flow velocity changes after ventricular taps and ventriculoperitoneal shunting. Childs Nery Syst 7: 452–457CrossRefGoogle Scholar
  24. 24.
    Horgan JG, Rumack CM, Hay T, et al. (1989) Absolute intracranial blood-flow velocities evaluated by duplex Doppler sonography in asymptomatic preterm and term neonates. AJR 152: 1059–1064PubMedGoogle Scholar
  25. 25.
    Taylor GA, Madsen JR (1996) Neonatal hydrocephalus hemodynamic response to fontanelle compression: correlation with intracranial pressure and need for shunt placement. Radiology 201: 685–689PubMedGoogle Scholar
  26. 26.
    Bruce DA, Berman WA, Schut L (1977) Cerebrospinal fluid pressure monitoring in children: physiology, pathology and clinical usefulness. Adv Pediatr 24: 233–290PubMedGoogle Scholar
  27. 27.
    Taylor GA (1992) Effect of scanning pressure on intracranial hemodynamics during transfontanellar duplex Doppler examinations. Radiology 185: 763–766PubMedGoogle Scholar

Copyright information

© Springer-Verlag Italia, Milano 1999

Authors and Affiliations

  • G. A. Taylor
    • 1
  1. 1.Department of RadiologyChildren’s Hospital and Harvard Medical SchoolBostonUSA

Personalised recommendations