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  • Perinatal/Neonatal Case Presentation
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Perinatal/Neonatal Case Presentation

Lenticulostriate vasculopathy in twin-to-twin transfusion syndrome

Abstract

Intracranial pathology is a common and important complication in extremely low birth weight babies. Lenticulostriate vasculopathy (LSV) is an abnormal finding on cranial ultrasounds of sick babies and has been associated with congenital infection, chromosomal aberration and twin-to-twin transfusion. We describe a previously unreported situation of LSV being detected in both donor and recipient twin. This pair of monochorionic, diamniotic twins was admitted to the Neonatal Intensive Care Unit at 28 weeks of gestation. The mother underwent an emergency caesarean section because ultrasound and Doppler studies showed stage III twin-to-twin transfusion syndrome. The first twin weighed 998 g and second twin weighed 600 g. The first twin had an uneventful stay, whereas the second twin needed prolonged continuous positive airway pressure and indomethacin for patent ductus arteriosus. Both of them developed LSV. The clinical significance of this condition on the neuro-developmental outcome of a neonate has not yet been fully determined.

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References

  1. Shankaran S, Johnson Y, Langer JC, Vohr BR, Fanaroff A, Wright L et al. Outcome of extremely-low-birth-weight infants at highest risk. Am J Obstet Gynecol 2004; 191: 1084–1091.

    Article  Google Scholar 

  2. Rumack CM, Johnson ML . Role of CT and ultrasound in neonatal brain imaging. J Comput Tomogr 1983; 7: 17–29.

    Article  CAS  Google Scholar 

  3. Grant EG, Willimas AL, Schellimger D . Intracranial calcification in the infant and neonate: evaluation by sonography and CT. Radiology 1985; 157: 63–68.

    Article  CAS  Google Scholar 

  4. Makhoul IR, Eisenstein I, Sujov P, Soudack M, Smolkin T, Tamir A et al. Neonatal lenticulostriate vasculopathy: further characterization. Arch Dis Child Fetal Neonatal Ed 2003; 88: F410–F414.

    Article  CAS  Google Scholar 

  5. Denbow ML, Battin MR, Cowan F, Azzopardi D, Edwards AD, Fisk NM . Neonatal cranial ultrasound findings in preterm twins complicated by severe fetofetal transfusion syndrome. Am J Obstet Gynecol 1998; 178 (3): 479–483.

    Article  CAS  Google Scholar 

  6. Lopriore E, Nagel HTC, Vandenbussche FPHA, Walters FJ . Long term neurodevelopment outcome in twin-to-twin transfusion syndrome. Am J Obstet Gynecol 2003; 189 (5): 1314–1319.

    Article  Google Scholar 

  7. El Ayoubi M, de Bethman O, Firition G, Monset-Couchard M . Neonatal lenticulostriate vasculopathy. Mid and long-term outcomes. Archives de Pediatrie 2004; 11 (1): 18–23.

    Article  CAS  Google Scholar 

  8. de Vries LS, Beek FJA, Stoutenbeek P . Lenticulostriate vasculopathy in twin-to-twin transfusion syndrome: sonographic and CT findings. Paediatric Radiol 1995; 25: S41–S42.

    Article  Google Scholar 

  9. Williams PL (Late), Bannister L, Berry M, Collins P, Dyson M, Dussel JE et al. Gray's Anatomy – The Anatomical Basis of Medicine and Surgery, 38th edn. Churchill Livingstone: London, 1995.

    Google Scholar 

  10. Quintero RA, Morales WJ, Allen MH, Bornick PW, Johnson PK, Kruger M . Staging of twin-twin transfusion syndrome. J Perinatol 1999; 19: 550–555.

    Article  CAS  Google Scholar 

  11. El Ayoubi M, de Bethmann O, Monset-Couchard M . Lenticulostriate echogenic vessels: clinical and sonographic study of 70 neonatal cases. Pediatr Radiol 2003; 33 (10): 697–703.

    Article  Google Scholar 

  12. Wang HS, Kuo MF, Chang TC . Sonographic lenticulostriate vasculopathy in infants: some associations and a hypothesis. Am J NeuroRadiol 1995; 16: 97–102.

    CAS  PubMed  Google Scholar 

  13. Wang HS, Kuo MF, Huang SC . Tic and attention-deficit hyperactivity disorders in children with sonographic lenticulostriate vasculopathy. Pediatric Res 1997; 41 (4 Part 2): 297.

    Article  Google Scholar 

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Correspondence to Y Kandasamy.

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Kandasamy, Y., Alcock, G. & Koh, T. Lenticulostriate vasculopathy in twin-to-twin transfusion syndrome. J Perinatol 26, 780–782 (2006). https://doi.org/10.1038/sj.jp.7211607

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