Mechanical Thrombectomy for Cerebral Venous Sinus Thrombosis in a Neonate
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ventricular septal defect is the commonest abnormality. Association with double outlet right ventricle has also been previously reported [5].
All India Institute of Medical Sciences, New Delhi; and 2Department of Cardiology, ESI Hospital and PGIMSR, Delhi; India.
Over 70% of patients with left ventricular diverticulum have Cantrell syndrome. The diverticulum originates from the left ventricular apex in these cases and may be associated with umbilical hernia and complex cardiac abnormalities. Ventricular aneurysm must be differentiated from diverticulum. A narrow mouth and synchronous contractility characterize a diverticulum. On the other hand, aneurysms show akinesia or paradoxic contractility of the outpouching, which is asynchronous with the rest of heart.
REFERENCES 1. Cantrell JR, Haller JA, Ravitch MM. A syndrome of congenital defects involving the abdominal wall, sternum, diaphragm, pericardium and heart. Surg Gynecol Obstet. 1958;107:602-14. 2. Jnah AJ, Newberry DM, England A. Pentalogy of Cantrell: Case report with review of the literature. Adv Neonatal Care. 2015;15:261-8. 3. O’gorman CS, Tortoriello TA, McMahon CJ. Outcome of children with pentalogy of Cantrell following cardiac surgery. Pediatr Cardiol. 2009;30:426-30. 4. Amato JJ, Douglas WI, Desai U, Burke S. Ectopia cordis. Chest Surg Clin North Am. 2000;10:297-316. 5. Singh N, Bera ML, Sachdev MS, Aggarwal N, Joshi R, Kohli V. Pentalogy of Cantrell with left ventricular diverticulum: A case report and review of literature. Congenital Heart Dis. 2010;5:454-7. 6. Williams AP, Marayati R, Beierle EA. Pentalogy of Cantrell. Semin Pediatr Surg. 2019;28:106-10.
Early surgical repair is indicated in cases of left ventricular diverticulum, as it may rupture spontaneously, thrombose or produce arrhythmias. It is generally recommended that the midline thoraco-abdominal defect is treated first and heart defects be corrected later [6]. We present this case in view of the interesting presentation in a neonate with a pulsatile umbilical swelling and cyanosis, and a good outcome after surgery. SAKSHI SACHDEVA,1 ANITA SAXENA,1 NIDHI BHIM SAIN2 AND VELAYOUDAM DEVAGOUROU3 Departments of 1Cardiology and
Mechanical Thrombectomy for Cerebral Venous Sinus Thrombosis in a Neonate
myoclonic seizures of upper extremities occurred, along with multiple apneic spells reappeared. Anticonvulsant treatment with intravenous phenobarbital was started. Laboratory examinations (blood count, plasma minerals and serum biochemistry, C-reactive protein, procalcitonin, coagulation profile) and lumbar puncture results were unremarkable, except for lactate concentration (4.75 mmol/L), hematocrit level (61%) and hemoglobin concentration (20 g/dL). Magnetic resonance imaging (MRI) with consecutive time-of-flight (TOF) venography and contrast enhanced T1WI revealed cerebral venous thrombosis. Superior sagittal sinus, right transverse sinus, straight sinus, vein of Galen and internal cerebral veins thrombosed, along with hemorrhage from right choroid plexus, and bilateral thalamic vasogen
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