Lenticulostriate vasculopathy also known as thalamostriate vasculopathy or mineralising vasculopathy 1, refers to the ultrasound appearance of hyperechogenic linear or branching tubular streaks in the thalami or basal ganglia of neonates.
Lenticulostriate vasculopathy has been reported on roughly 2-5% of neonatal cranial ultrasounds 1-4. The incidence in preterm babies might be as high as 20% 9. It has been described in association with numerous diseases, most commonly congenital cytomegalovirus (CMV) infection, perinatal hypoxia, and chromosomal anomalies.
Lenticulostriate vasculopathy is most often encountered on neonatal cranial ultrasounds performed for another reason.
It is sometimes associated with amorphous basophilic deposits in the walls of medium-sized perforating arteries 6. An initial hypercellular vasculopathy can progress to perivascular mineralisation.
However, a frank pathologic correlate of the ultrasound findings has not always been found. Moreover, the sonographic anomalies have been shown to often spontaneously regress.
High-frequency grayscale ultrasound shows linear or branching echogenicities in the thalami or basal ganglia.
Often, no convincing correlate is seen on CT or MRI. At times, punctate calcifications in the basal ganglia are noted.
Treatment and prognosis
Although lenticulostriate vasculopathy has been reported in association with countless diseases, this does not imply causation, especially since most studies have been retrospective. It can be incidentally found in neonates screened for other reasons who go on to have normal neurological development. It has been associated with a higher risk of neonatal intraventricular hemorrhage 1. There have been reported cases of basal ganglia and thalamic ischemic infarcts following minor trauma in neonates with lenticulostriate vasculopathy 9.
- 1. Mittendorf R, Covert R, Pryde PG, Lee KS, Ben-Ami T, Yousefzadeh D. Association between lenticulostriate vasculopathy (LSV) and neonatal intraventricular hemorrhage (IVH). (2004) Journal of perinatology : official journal of the California Perinatal Association. 24 (11): 700-5. doi:10.1038/sj.jp.7211173 - Pubmed
- 2. Shin HJ, Kim MJ, Lee HS, Namgung R, Park KI, Lee MJ. Imaging patterns of sonographic lenticulostriate vasculopathy and correlation with clinical and neurodevelopmental outcome. (2015) Journal of clinical ultrasound : JCU. 43 (6): 367-74. doi:10.1002/jcu.22196 - Pubmed
- 3. Weber K, Riebel T, Nasir R. Hyperechoic lesions in the basal ganglia: an incidental sonographic finding in neonates and infants. (1992) Pediatric radiology. 22 (3): 182-6. Pubmed
- 4. Makhoul IR, Eisenstein I, Sujov P, Soudack M, Smolkin T, Tamir A, Epelman M. Neonatal lenticulostriate vasculopathy: further characterisation. (2003) Archives of disease in childhood. Fetal and neonatal edition. 88 (5): F410-4. Pubmed
- 5. Coley BD, Rusin JA, Boue DR. Importance of hypoxic/ischemic conditions in the development of cerebral lenticulostriate vasculopathy. (2000) Pediatric radiology. 30 (12): 846-55. doi:10.1007/s002470000322 - Pubmed
- 6. Teele RL, Hernanz-Schulman M, Sotrel A. Echogenic vasculature in the basal ganglia of neonates: a sonographic sign of vasculopathy. (1988) Radiology. 169 (2): 423-7. doi:10.1148/radiology.169.2.2845473 - Pubmed
- 7. Koral K, Sisman J, Pritchard M, Rosenfeld CR. Lenticulostriate vasculopathy in neonates: Perspective of the radiologist. (2015) Early human development. 91 (7): 431-5. doi:10.1016/j.earlhumdev.2015.04.003 - Pubmed
- 8. E G Grant, A L Williams, D Schellinger, T L Slovis. Intracranial calcification in the infant and neonate: evaluation by sonography and CT. (1985) Radiology. 157 (1): 63-8. doi:10.1148/radiology.157.1.2994172 - Pubmed
- 9. Ivanov I, Zlatareva D, Pacheva I, Panova M. Does lenticulostriate vasculopathy predipose to ischemic brain infarct? A case report. (2012) Journal of clinical ultrasound : JCU. 40 (9): 607-10. doi:10.1002/jcu.21922 - Pubmed
- 10. Wang HS, Kuo MF, Chang TC. Sonographic lenticulostriate vasculopathy in infants: some associations and a hypothesis. (1995) AJNR. American journal of neuroradiology. 16 (1): 97-102. Pubmed