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Subependymal Cerebral Hemorrhage in Infancy

Subependymal Cerebral Hemorrhage in Infancy Abstract SUBEPENDYMAL cerebral hemorrhage with intraventricular inundation, occurring almost exclusively in premature infants,1-9 has been encountered in approximately 15% of premature babies autopsied in the neonatal period.10 A series of sporadic reports suggested the frequent occurrence of subependymal bleeding in premature infants was due to possible developmental factors such as: (1) thin-walled veins with large diameters that lack adequate supporting fibers in the subependymal matrix,6,11 (2) congenital vascular defects or early vascular injuries,12 or (3) thin-walled terminal veins that are unusually susceptible to venous congestion.6,8,13 The most prevalent theory is that asphyxia produces generalized venous congestion and damage to the cerebral blood vessels which is sufficient to rupture the terminal veins. The purpose of this report is to present a comprehensive description of the clinicopathological findings of 30 infants who had subependymal bleeding at autopsy and to elucidate further the possible existence of a special predisposition References 1. Ylppö, A.: Origin of Hemorrhages in Prematures and the Newborn , Z Kinderheilk 38:32-45, 1924.Crossref 2. Schwartz, P.: Die traumatischen Schädigungen des Zentralnervensystems durch die Geburt: Anatomische Untersuchungen , Ergebn Inn Med Kinderheilk 31:165-372, 1927. 3. Rydberg, E.: Cerebral Injury in New-Born Children Consequent on Birth Trauma: With an Inquiry Into the Normal and Pathological Anatomy of the Neuroglia , Acta Path Microbiol Scand , (suppl 10) , 1-247, 1932. 4. Hemsath, F.A.: Ventricular Cerebral Hemorrhage in the Newborn Infant: A Pathologic and Etiologic Study of Twenty Cases , Amer J Obstet Gynec 28:343-354, 1934. 5. Craig, W.S.: Intracranial Hemorrhage in the Newborn , Arch Dis Child 13:89-124, 1938.Crossref 6. Gruenwald, P.: Subependymal Cerebral Hemorrhage in Premature Infants, and Its Relation to Various Injurious Influences at Birth , Amer J Obstet Gynec 61:1285-1292, 1951. 7. Arey, J.B., and Dent, J.: Causes of Fetal and Neonatal Death With Special Reference to Pulmonary and Inflammatory Lesions , J Pediat 42:1-25, 1953.Crossref 8. Gröntoft, O.: Intracranial Haemorrhage and Blood-Brain Barrier Problems in the New-Born: Pathologico-Anatomical and Experimental Investigation , Acta Path Microbiol Scand , (suppl 100) , pp 1-109, 1954. 9. Haller, E.S.; Nesbitt, R.E.L., Jr.; and Anderson, G.W.: Clinical and Pathological Concepts of Gross Intracranial Hemorrhage in Perinatal Mortality , Obstet Gynec Survey 11: 179-204, 1956.Crossref 10. Britton, R.C.; Weston, J.T.; and Landing, B.H.: Plastic Injection Technics in Pediatric Pathology, With Particular Reference to Roentgenographic Study of Injected Specimens , Bull Int Assoc Med Museums 31:124-166, 1950. 11. Ruckensteiner, E., and Zöllner, F.: Über die Blutungen im Gebiete der Vena terminalis bei Neugeborenen , Frankfurt Z Path 37:568-578, 1929. 12. Schloss, O.M.: Discussion in Hemsath, F.A.: Ventricular Cerebral Hemorrhage in the Newborn Infant: A Pathologic and Etiologic Study of Twenty Cases , Amer J Obstet Gynec 28: 343-354, 1934. 13. Schwartz, P.: Birth Injuries of the Newborn , New York: Hafner Publishing Co., 1961. 14. Farber, S.: The Postmortem Examination , Springfield, Ill: Charles C Thomas, Publisher, 1937, pp 167-169. 15. His, W.: Die Neuroblasten und deren Entstehung im embryonalen Mark , Arch Anat Entw , 1889, pp 249-300. 16. Patz, A.: Clinical and Experimental Studies on Role of Oxygen in Retrolental Fibroplasia , Trans Amer Acad Ophth Otolaryng 58:45-50, 1954. 17. Patz, A., et al: Oxygen Studies in Retrolental Fibroplasia: II. The Production of the Microscopic Changes of Retrolental Fibroplasia in Experimental Animals , Amer J Ophthal 36:1511-1522, 1953. 18. Talanti, S.: Studies on the Subcommissural Organ in Some Domestic Animals , Ann Med Exp Fenn , (suppl 9) , p 36, 1958. 19. Corner, B.: The Diagnosis, Care and Disorders of the Premature Infant , London: Cassell & Company, Ltd., 1960. 20. Usher, R.: The Respiratory Distress Syndrome of Prematurity, Clinical and Therapeutic Aspects , Pediat Clin N Amer 8:525-538, 1961. 21. Morison, J.E.: Establishment of Extra-Uterine Respirations , J Obstet Gynaec Brit Comm 56:393-403, 1949.Crossref 22. Potter, E.L.: Pathology of the Fetus and Newborn , ed 2, Chicago: Year Book Medical Pubs., Inc., 1961, pp 96-102. 23. Schwartz, P., and Fink, L.: Morphologie und Entstehung der geburtstraumatischen Blutungen im Gehirn und Schädel des Neugeborenen , Z Kinderheilk 40:427-474, 1926.Crossref 24. Schlesinger, B.: Venous Drainage of the Brain, With Special Reference to Galenic System , Brain 62:274-291, 1939.Crossref 25. Ramón y Cajal, S.: Histologie du système nerveux de l'homme et des vertebrés , Madrid: Consejo Sup Invest Cient, 1952. 26. Sidman, R.L.; Miale, I.L.; and Feder, N.: Cell Proliferation and Migration in the Primitive Ependymal Zone, an Autoradiographic Study of Histogenesis in the Nervous System , Exp Neurol 1:322-333, 1959.Crossref 27. Schaper, A.: Die frühesten Differenzierungsvorgänge im Centralnervensystem , Arch Entwckmech Organ 5:81-132, 1897. 28. Sauer, F.C.: Mitosis in the Neural Tube , J Comp Neurol 62:377-405, 1935.Crossref 29. Klosovskii, B.N.: The Development of the Brain and Its Disturbance by Harmful Factors , New York: Macmillan Co., 1963. http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

Subependymal Cerebral Hemorrhage in Infancy

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Publisher
American Medical Association
Copyright
Copyright © 1965 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1965.02090030555007
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Abstract

Abstract SUBEPENDYMAL cerebral hemorrhage with intraventricular inundation, occurring almost exclusively in premature infants,1-9 has been encountered in approximately 15% of premature babies autopsied in the neonatal period.10 A series of sporadic reports suggested the frequent occurrence of subependymal bleeding in premature infants was due to possible developmental factors such as: (1) thin-walled veins with large diameters that lack adequate supporting fibers in the subependymal matrix,6,11 (2) congenital vascular defects or early vascular injuries,12 or (3) thin-walled terminal veins that are unusually susceptible to venous congestion.6,8,13 The most prevalent theory is that asphyxia produces generalized venous congestion and damage to the cerebral blood vessels which is sufficient to rupture the terminal veins. The purpose of this report is to present a comprehensive description of the clinicopathological findings of 30 infants who had subependymal bleeding at autopsy and to elucidate further the possible existence of a special predisposition References 1. Ylppö, A.: Origin of Hemorrhages in Prematures and the Newborn , Z Kinderheilk 38:32-45, 1924.Crossref 2. Schwartz, P.: Die traumatischen Schädigungen des Zentralnervensystems durch die Geburt: Anatomische Untersuchungen , Ergebn Inn Med Kinderheilk 31:165-372, 1927. 3. Rydberg, E.: Cerebral Injury in New-Born Children Consequent on Birth Trauma: With an Inquiry Into the Normal and Pathological Anatomy of the Neuroglia , Acta Path Microbiol Scand , (suppl 10) , 1-247, 1932. 4. Hemsath, F.A.: Ventricular Cerebral Hemorrhage in the Newborn Infant: A Pathologic and Etiologic Study of Twenty Cases , Amer J Obstet Gynec 28:343-354, 1934. 5. Craig, W.S.: Intracranial Hemorrhage in the Newborn , Arch Dis Child 13:89-124, 1938.Crossref 6. Gruenwald, P.: Subependymal Cerebral Hemorrhage in Premature Infants, and Its Relation to Various Injurious Influences at Birth , Amer J Obstet Gynec 61:1285-1292, 1951. 7. Arey, J.B., and Dent, J.: Causes of Fetal and Neonatal Death With Special Reference to Pulmonary and Inflammatory Lesions , J Pediat 42:1-25, 1953.Crossref 8. Gröntoft, O.: Intracranial Haemorrhage and Blood-Brain Barrier Problems in the New-Born: Pathologico-Anatomical and Experimental Investigation , Acta Path Microbiol Scand , (suppl 100) , pp 1-109, 1954. 9. Haller, E.S.; Nesbitt, R.E.L., Jr.; and Anderson, G.W.: Clinical and Pathological Concepts of Gross Intracranial Hemorrhage in Perinatal Mortality , Obstet Gynec Survey 11: 179-204, 1956.Crossref 10. Britton, R.C.; Weston, J.T.; and Landing, B.H.: Plastic Injection Technics in Pediatric Pathology, With Particular Reference to Roentgenographic Study of Injected Specimens , Bull Int Assoc Med Museums 31:124-166, 1950. 11. Ruckensteiner, E., and Zöllner, F.: Über die Blutungen im Gebiete der Vena terminalis bei Neugeborenen , Frankfurt Z Path 37:568-578, 1929. 12. Schloss, O.M.: Discussion in Hemsath, F.A.: Ventricular Cerebral Hemorrhage in the Newborn Infant: A Pathologic and Etiologic Study of Twenty Cases , Amer J Obstet Gynec 28: 343-354, 1934. 13. Schwartz, P.: Birth Injuries of the Newborn , New York: Hafner Publishing Co., 1961. 14. Farber, S.: The Postmortem Examination , Springfield, Ill: Charles C Thomas, Publisher, 1937, pp 167-169. 15. His, W.: Die Neuroblasten und deren Entstehung im embryonalen Mark , Arch Anat Entw , 1889, pp 249-300. 16. Patz, A.: Clinical and Experimental Studies on Role of Oxygen in Retrolental Fibroplasia , Trans Amer Acad Ophth Otolaryng 58:45-50, 1954. 17. Patz, A., et al: Oxygen Studies in Retrolental Fibroplasia: II. The Production of the Microscopic Changes of Retrolental Fibroplasia in Experimental Animals , Amer J Ophthal 36:1511-1522, 1953. 18. Talanti, S.: Studies on the Subcommissural Organ in Some Domestic Animals , Ann Med Exp Fenn , (suppl 9) , p 36, 1958. 19. Corner, B.: The Diagnosis, Care and Disorders of the Premature Infant , London: Cassell & Company, Ltd., 1960. 20. Usher, R.: The Respiratory Distress Syndrome of Prematurity, Clinical and Therapeutic Aspects , Pediat Clin N Amer 8:525-538, 1961. 21. Morison, J.E.: Establishment of Extra-Uterine Respirations , J Obstet Gynaec Brit Comm 56:393-403, 1949.Crossref 22. Potter, E.L.: Pathology of the Fetus and Newborn , ed 2, Chicago: Year Book Medical Pubs., Inc., 1961, pp 96-102. 23. Schwartz, P., and Fink, L.: Morphologie und Entstehung der geburtstraumatischen Blutungen im Gehirn und Schädel des Neugeborenen , Z Kinderheilk 40:427-474, 1926.Crossref 24. Schlesinger, B.: Venous Drainage of the Brain, With Special Reference to Galenic System , Brain 62:274-291, 1939.Crossref 25. Ramón y Cajal, S.: Histologie du système nerveux de l'homme et des vertebrés , Madrid: Consejo Sup Invest Cient, 1952. 26. Sidman, R.L.; Miale, I.L.; and Feder, N.: Cell Proliferation and Migration in the Primitive Ependymal Zone, an Autoradiographic Study of Histogenesis in the Nervous System , Exp Neurol 1:322-333, 1959.Crossref 27. Schaper, A.: Die frühesten Differenzierungsvorgänge im Centralnervensystem , Arch Entwckmech Organ 5:81-132, 1897. 28. Sauer, F.C.: Mitosis in the Neural Tube , J Comp Neurol 62:377-405, 1935.Crossref 29. Klosovskii, B.N.: The Development of the Brain and Its Disturbance by Harmful Factors , New York: Macmillan Co., 1963.

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Nov 1, 1965

References