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Neonatal Temporal Lobar Hemorrhage Secondary to Thrombosis of the Vein of Labbé

Journal of Perinatology volume 25, pages 605–607 (2005)Cite this article

Lobar intracerebral hemorrhage (LH) in full-term neonates is rare. Review of the literature showed that 27 cases of LH in full-term newborns have been reported so far.1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 Hanigan et al.13 in their large series reported only four cases of LH out of 33 cases of term babies with symptomatic intracranial hemorrhage in a 5-year period. LH refers to localized bleeding into one specific area of the brain. It is most likely due to bleeding into parenchyma after infarction has occurred as a result of arterial or venous occlusion. The etiology of LH is idiopathic in majority of the cases. The literature review showed that only a third of reported LH cases had an identifiable risk factor.1, 2, 3, 4, 5, 6, 7, 8, 9, 10, 11, 12 Differential diagnosis of LH in term neonates include birth trauma, perinatal asphyxia, arteriovenous malformation, intracranial tumors, coagulopathies, venous occlusion and infections (particularly herpes encephalitis).

Recognition of characteristic vascular territories allows identification of the involved vessels in full-term neonates with arterial infarction. Arterial vascular beds in term babies are similar to those in adults, and regions affected by occlusion of specific major intracranial arteries are well documented. In contrast, the localization of specific territories of cortical venous drainage is less precise with the existence of many venous variants. The Vein of Labbé is one of the more consistent cortical veins, which runs along the lateral surface of the left temporal lobe in an anterior-to-posterior direction and drains into the transverse sinus.2 Thrombosis of this vein results in a typical pattern of hemorrhagic infarction in the lateral aspect of the underlying temporal lobe with sparing of the insular cortex. The Vein of Trolard is another important cortical (parietal lobe) vein, which drains superiorly into the sagittal sinus near the central sulcus. Owing to their size and location, these veins are of particular interest to neurosurgeons in approaching lesions in the temporal and parietal lobes.

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Authors and Affiliations

  1. Department of Pediatric Hematology/Oncology, Children's Hospital, Columbus, OH, USA

    Ram Kalpatthi MD & Carol A Blanchong MD

  2. Department of Pediatric Radiology, Children's Hospital, Columbus, OH, USA

    Brian D Coley MD & Jerome A Rusin MD

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  1. Ram Kalpatthi MD
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  2. Brian D Coley MD
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  4. Carol A Blanchong MD
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Kalpatthi, R., Coley, B., Rusin, J. et al. Neonatal Temporal Lobar Hemorrhage Secondary to Thrombosis of the Vein of Labbé. J Perinatol 25, 605–607 (2005). https://doi.org/10.1038/sj.jp.7211298

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