Neonatal vein of Labbé infarction size is associated with long-term language outcomes

Publication date: Available online 1 April 2017
Source:Pediatric Neurology
Author(s): Kristen L. Benninger, Lynne Ruess, Laurel A. Slaughter, Nathalie L. Maitre, Jerome A. Rusin
BackgroundThe vein of Labbé (VOL) is a superficial cortical vein which drains the lateral surface of the temporal lobe. Thrombosis of the VOL can occur in the neonatal period. The developmental outcomes of infants who had VOL thrombosis are unknown as few studies of outcomes exist.MethodsRetrospective chart review of infants born ≥34 weeks gestation, diagnosed with VOL thrombosis and/or infarction on neuroimaging during the first 30 days of life. Size of each temporal lobe infarction was estimated based on number of temporal lobe's segments involved. Primary outcomes were presence of major neurodevelopmental impairments in childhood and Bayley scores at 2 years.ResultsOur cohort of 19 infants had a median gestational age of 38 weeks [IQR 36-39] and mean birthweight 2892±920 grams. The most common presenting symptoms of VOL thrombosis and infarction of surrounding tissue were seizures, apnea, lethargy and either hyper- or hypotonia. At the latest clinical follow-up appointment documented in the electronic medical record (mean 4.4±3.08 years), 44% had major neurodevelopmental impairment. Patients with large VOL infarctions had significantly worse average Bayley scores than those with small to moderate lesions, differences in language composite were statistically significant (72.7 vs 107.8, p = 0.017).ConclusionsNeonates with large VOL infarctions are more likely to have poor language outcomes. This suggests a need for targeted surveillance to ensure early identification of deficits and referral for intervention.



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