Thalamic lesions in neonates evaluated by ultrasound: reported cases in five years at the Perinatal Maternal Institute. Lima, Perú

Abstract

Objetive: assess the ultrasound characteristics of neonatal thalamic damage (hemorrhage or infarction) and the associated prenatal factors. 

Material and methods: its a retrospective descriptive study of a series of neonates cases with thalamic damage. We review the data of the ultrasound report from 3 562 neonates, since august 1999 until august 2004. The transfontanellar ultrasound studies were performed in the Diagnostic Imaging and Neonatal Intensive Care Services. An ultrasound equipment with micro-convex transducer of 5 and 7.5 Mhz was used. Results: there were 8 (0,2%) cases of thalamic damage: 6 unilateral and 2 bilateral, 5 in preterm neonates and 3 in term neonates. The average weight of the preterm newborns was 1,490 gr, and in the term newborns was 3,210 gr. The average gestational time in newborns was 30,4 weeks and 39,3 weeks for the term ones. The prenatal factors were: asphyxia (4), coagulopathy (3), premature detachment of the placenta (1), prolapse of umbilical cord (1), and undetermined (3). Five out 5 neonates died. 
Conclusion: the thalamic damage is a rare presentation, and it was associated fundamentally to the severe hypoxic-isquemic encephalopathy and coagulopathy problems. There were two ways of presentation: bilateral thalamic damage in term neonates and unilateral thalamic damage in preterm neonates.