Objective Lenticulostriate vasculopathy (LSV) can be seen on neonatal cranial ultrasound scans (cUS). It has been associated with various clinical conditions. Studies in preterm infants are limited. Our aim was to evaluate for LSV in very preterm (VPT) infants <32 weeks: incidence, characteristics, association with clinical parameters, aetiology, magnetic resonance imaging (MRI) equivalent.

Methods In VPT sequential cUS were performed from birth until term and evaluated for LSV and other cerebral abnormalities. The incidence of LSV and various clinical parameters were calculated. Term MRI was assessed for deep grey matter changes.

Results In 24/129 VPT (19%; 10 of multiple births) LSV was encountered. Mean gestational age and weight at birth were 28.7 weeks and 1175 g. Mean postnatal ages when LSV was first and last seen were 27 and 81 days, respectively; mean total duration was 60 days. In three infants (all twins) it was seen at birth and in 17 still at term. It was unilateral in 17 infants and bilateral in seven, and appeared punctate in three, linear in 14 and branching in seven. It was associated with female gender (p = 0.02) and negatively associated with hypotension (p = 0.04). No deep grey matter changes were seen on MRI.

Conclusions LSV was frequently seen on sequential cUS in VPT infants and was mostly unilateral, linear, and first seen several weeks after birth. It was associated with multiple birth and female gender and negatively associated with hypotension. No MRI equivalent was found. Further study is needed to assess the origin and implications of LSV.