Endoscopic ultrasonic aspiration of an intraparenchymal hematoma in a newborn

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  • 1 Department of Neurosurgery, Division of Pediatric Neurosurgery, Baylor College of Medicine, Texas Children’s Hospital, Houston, Texas; and
  • 2 Department of Neurosurgery, Division of Pediatric Neurosurgery, Northwestern University, Lurie Children’s Hospital, Chicago, Illinois
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Neonatal intracerebral hemorrhage is associated with substantial morbidity and mortality. Treatment is largely conservative, though interventions to evacuate intraventricular and intraparenchymal hematomas (IPHs) have been applied. Endoscopic ultrasonic aspiration for the treatment of IPH has increasingly been shown to be a useful strategy in adults; however, it has not been studied in children, and the technology has been more commonly applied to intraventricular hemorrhage (IVH). Here, the authors describe, to the best of their knowledge, the first use of endoscopic ultrasonic aspiration for IPH in a newborn.

An 8-week-old female presented with IPH secondary to left M3 aneurysm rupture, which was treated with coil embolization for aneurysm securement and vessel sacrifice, followed by IPH evacuation using endoscopic ultrasonic aspiration. Through applying this approach in a newborn, the authors gained technical insight not previously reported in the application of this technique in similar cases in adults or in cases of IVH. They highlight this case to share learning points and technical challenges regarding the application of endoscopic ultrasonic aspiration in a newborn along with learning points for imaging and visualization. Endoscopic ultrasonic aspiration can be used to treat IPH in select newborns. Further study is needed to improve efficacy and ease when applying this approach in very young patients.

ABBREVIATIONS cEEG = continuous electroencephalography; ICH = intracerebral hemorrhage; IPH = intraparenchymal hematoma; IVH = intraventricular hemorrhage.

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Contributor Notes

Correspondence Sandi Lam: Lurie Children’s Hospital, Northwestern University Feinberg School of Medicine, Chicago, IL. sandilam@gmail.com; slam@luriechildrens.org.

INCLUDE WHEN CITING Published online October 2, 2020; DOI: 10.3171/2020.6.PEDS2042.

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

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