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Peer-reviewedCC BY-NC-NDRadiology Case Reports

Lenticulostriate vasculopathy in neonates: An imaging marker with heterogeneous clinical significance

  1. 1Department of Radiology, Children’s Hospital, Ibn Sina University Hospital Center, Rabat, Morocco

Abstract

Lenticulostriate vasculopathy (LSV) is a relatively common cranial ultrasound finding in neonates, characterized by linear or branching hyperechogenic striations within the basal ganglia and/or thalamus along the lenticulostriate arteries. Although initially associated with congenital infections, particularly cytomegalovirus (CMV), LSV is now recognized in a broad range of clinical settings, and its prognostic significance remains controversial. We report 3 neonatal cases illustrating the heterogeneous contexts in which LSV may occur. The first case was a term male neonate with transient respiratory distress and normal neurological examination; cranial ultrasound on day 3 showed unilateral right-sided fine linear striations in the basal ganglia without parenchymal abnormalities. Infectious workup was negative and outcome was favorable. The second case involved a 36-week male neonate born after acute fetal distress, with severe respiratory distress requiring resuscitation. Cranial ultrasound demonstrated unilateral left-sided LSV without hemorrhagic or hypoxic-ischemic lesions; subsequent brain MRI was normal, with favorable follow-up and slight regression of the ultrasound abnormalities. The third case was a term female neonate with prolonged jaundice, hypotonia, hepatosplenomegaly, thrombocytopenia, and abnormal liver function tests. Cranial ultrasound revealed bilateral branching striations, and congenital CMV infection was confirmed by urine PCR. These cases highlight the nonspecific nature of LSV, which may occur as an isolated finding, with perinatal hypoxic or hemodynamic disturbances, or with congenital infection. Recognition of LSV should be interpreted in the clinical context, with targeted investigation when abnormalities are present, while isolated forms may have a favorable outcome.

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BibTeX
@article{mehdielazouzi2026lenticulostriate,
  title = {{Lenticulostriate vasculopathy in neonates: An imaging marker with heterogeneous clinical significance}},
  author = {Mehdi El Azouzi, MD and Lina Belkouchi, PhD and Siham El Haddad, PhD and Nazik Allali, PhD and Latifa Chat, PhD},
  journal = {Radiology Case Reports},
  year = {2026},
  month = oct,
  doi = {10.1016/j.radcr.2026.10.005},
  url = {https://doi.org/10.1016/j.radcr.2026.10.005},
  note = {CC BY-NC-ND},
}
RIS
TY  - JOUR
TI  - Lenticulostriate vasculopathy in neonates: An imaging marker with heterogeneous clinical significance
AU  - Mehdi El Azouzi, MD
AU  - Lina Belkouchi, PhD
AU  - Siham El Haddad, PhD
AU  - Nazik Allali, PhD
AU  - Latifa Chat, PhD
PY  - 2026
DA  - 2026/10/22
JO  - Radiology Case Reports
DO  - 10.1016/j.radcr.2026.10.005
UR  - https://doi.org/10.1016/j.radcr.2026.10.005
AB  - Lenticulostriate vasculopathy (LSV) is a relatively common cranial ultrasound finding in neonates, characterized by linear or branching hyperechogenic striations within the basal ganglia and/or thalamus along the lenticulostriate arteries. Although initially associated with congenital infections, particularly cytomegalovirus (CMV), LSV is now recognized in a broad range of clinical settings, and its prognostic significance remains controversial. We report 3 neonatal cases illustrating the heterogeneous contexts in which LSV may occur. The first case was a term male neonate with transient respiratory distress and normal neurological examination; cranial ultrasound on day 3 showed unilateral right-sided fine linear striations in the basal ganglia without parenchymal abnormalities. Infectious workup was negative and outcome was favorable. The second case involved a 36-week male neonate born after acute fetal distress, with severe respiratory distress requiring resuscitation. Cranial ultrasound demonstrated unilateral left-sided LSV without hemorrhagic or hypoxic-ischemic lesions; subsequent brain MRI was normal, with favorable follow-up and slight regression of the ultrasound abnormalities. The third case was a term female neonate with prolonged jaundice, hypotonia, hepatosplenomegaly, thrombocytopenia, and abnormal liver function tests. Cranial ultrasound revealed bilateral branching striations, and congenital CMV infection was confirmed by urine PCR. These cases highlight the nonspecific nature of LSV, which may occur as an isolated finding, with perinatal hypoxic or hemodynamic disturbances, or with congenital infection. Recognition of LSV should be interpreted in the clinical context, with targeted investigation when abnormalities are present, while isolated forms may have a favorable outcome.
SN  - 1930-0433
ER  -