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The Sonographic Detection of Intracranial Hemorrhage Due to Alloimmune Thrombocytopenia

Glenn A. Rouse, MD

Department of Diagnostic Ultrasound, Loma Linda University Medical Center, Loma Linda, California

Marie de Lange, RDMS, RDCS

Department of Diagnostic Ultrasound, Loma Linda University Medical Center, Loma Linda, CA 92354

Antranik A. Bedros, MD

Elmer P. Sakala, MD

Department of Diagnostic Ultrasound, Loma Linda University Medical Center, Loma Linda, California

Alloimmune thrombocytopenia is a rare condition in which antibodies from the mother's circulation cross the placenta and destroy the platelets in the fetus. Approximately 14% of affected fetuses or neonates develop intracranial hemorrhage, leading to death or long-term central nervous system disabilities. After treating two such cases, 26 previously reported cases of alloimmune thrombocytopenia with intracranial hemorrhage were examined to discover if these hemorrhages exhibit a typical sonographic appearance, course, and time of hemorrhage. When intracranial hemorrhage occurs in cases of alloimmune thrombocytopenia, it has a typical appearance in 76% of cases: a large hematoma in the center of the cerebral hemisphere. There is no difference between genders in the occurrence of alloimmune thrombocytopenia unless hemorrhage occurs: 72% of neonates with alloimmune thrombocytopenia and intracranial hemorrhage are male. Intracranial hemorrhage occurs before labor and delivery in 76% of cases. Sonographers cannot depend on a history of the condition in previous pregnancies as an indication of alloimmune thrombocytopenia: only 35% of neonates with alloimmune thrombocytopenia and hemorrhage have previously affected siblings.

Key Words: alloimmune thrombocytopenia • platelet antigens • anti-platelet antibodies • intracranial hemorrhage • porencephaly • sonography • hydrocephalus

Journal of Diagnostic Medical Sonography, Vol. 8, No. 5, 249-255 (1992)
DOI: 10.1177/875647939200800504


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