Severe thrombocytopenia is sufficient for fetal and neonatal intra-cerebral hemorrhage to occur.

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Intra-cerebral hemorrhage (ICH) has a devastating impact on the neonatal population. Whether thrombocytopenia is sufficient to cause ICH in neonates is debated. In this study we have comprehensively investigated the consequences of severe thrombocytopenia on the integrity of the cerebral vasculature using two orthogonal approaches: genetically, by studying embryogenesis in the Nfe2-/- mouse line; and using biologics (anti-GP1Ba antibodies) to induce severe thrombocytopenia at defined times during development. Using a mouse model, we present data herein that not only demonstrate that platelets are required throughout fetal development and into neonatal life to maintain the integrity of the cerebral vasculature to prevent hemorrhage, but also that the location of cerebral hemorrhage is dependent on the timing during development when thrombocytopenia occurs. Importantly, this study demonstrates that thrombocytopenia-associated fetal/neonatal ICH occurs within regions of the brain which, in humans, could lead to neurological damage.

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Authors: Alison Farley, Sarah Lloyd, Merle Dayton, Christine Biben, Olivia Stonehouse, Samir Taoudi