PEDIATRICS Vol. 91 No. 6 June 1993, pp. 1219-1220
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On the Association of Unilateral Thalamic Hemorrhage and Urinary Tract Infection

ELKE H. ROLAND MD1, OLOF FLODMARK MD, PHD1, and ALAN HILL MD, PHD1

1 University of British Columbia, British Columbia's Children's Hospital, Vancouver, British Columbia, Canada

In Reply.—

Rooman et al report on an infant who developed thalamic hemorrhage associated with a urinary tract infection caused by Escherichia coli. They speculate that E coli endotoxin may enhance clotting potential via the extrinsic cascade and decrease endothelial thrombomodulin expression, thus shifting the hemostatic balance and increasing the risk of cerebral venous infarction.

In our article,1 we suggest that the most probable mechanism causing thalamic/intraventricular hemorrhage in the full-term newborn is thrombosis of the deep cerebral veins resulting in infarction and secondary hemorrhage in the thalamic region.