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Correspondence to Author: Rita Lages Pereira¹, Mariana Oliveira Pereira¹,Rita Aldeia da Silva¹, Ana Rita Dias², João SoaresFernandes³, Sílvia Mota², Carla Sá². 

¹Pediatrics Department, Unidade Local de Saúde do Hospital de Braga.
² Neonatal Intensive Care Unit, Pediatrics Department, Unidade Local de Saúde do Hospital de Braga.
³Neurorradiology Department, Unidade Local de Saúde do Hospital de Braga.

DOI: 10.52338/jocp.2025.4347

Abstract:

Introduction:Deep medullary vein thrombosis (DMVT) is a rare but significant cause of neonatal stroke, characterized by venous congestion and thrombosis in subcortical white matter. Early identification is crucial due to its association with long-term neurological sequelae. Case Description: We report the case of a term neonate presenting with focal seizures at 48 hours of life. Prenatal history was significant for fetal growth restriction and vacuum-assisted delivery. Neuroimaging revealed radial, fan-shaped T2 hypointense lesions in periventricular white matter as hallmark findings of DMVT. Compound heterozygosity for MTHFR mutations was identified. Seizure management with phenobarbital and supportive care were prioritized, with serial imaging showing favorable evolution. At 12 months, the child exhibited an unremarkable neurologic examination and appropriate psychomotor development without recurrent seizures. Discussion/Conclusion:This case highlights the importance of early neuroimaging in neonates with seizures or atypical neurological presentations. Enhanced awareness and understanding of DMVT among clinicians may reduce diagnostic delays, ultimately improving outcomes. The absence of standardized treatment protocols underscores the need for further research.

Citation:

Dr.Rita Lages Pereira, Deep Medullary Vein Thrombosis in a Term Neonate. Journal of Clinical Pediatrics 2025.