Age: 4 days (born at 38 weeks)
Sex: Male
Indication: Seizure
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Case #34
Findings
- Extensive T1 signal hyperintensity and susceptibility artifact in the right greater than left lateral ventricles with multiple areas of susceptibility artifact in the periventricular white matter bilaterally
- Small T1 hyperintense subdural collections along the left parietooccipital convexity and in the posterior fossa
- Mass effect in the right cerebral hemisphere results in 4 mm right to left midline shift without evidence of herniation
- Enlargement of the right greater than left lateral ventricles with periventricular T2/FLAIR hyperintensity
- Multifocal restricted diffusion in the bilateral anterior watershed zones, with some areas of associated T1 signal hyperintensity and susceptibility artifact
- Additional areas of restricted diffusion involving the bilateral posterior limbs of the internal capsules and splenium of the corpus callosum
- Scalp hematoma superficial to the galea aponeurosis
Diagnosis
- Newborn intraventricular hemorrhage (IVH), infarcts, and seizure
- Caput succedaneum
Sample Report
Extensive intraventricular hemorrhage in the right greater than left lateral ventricles with multiple small parenchymal hematomas in the bilateral periventricular white matter. Associated hydrocephalus with enlargement of the right greater than left lateral ventricles and transependymal edema. Additionally, mass effect in the right cerebral hemisphere results in 4 mm right to left midline shift without evidence of herniation.
Small acute subdural hematomas along the left parietooccipital convexity and in the posterior fossa.
Findings concerning for multifocal small acute infarcts along the bilateral anterior watershed zones, some of which have associated hemorrhage.
Additional areas of restricted diffusion involving the bilateral posterior limbs of the internal capsules and splenium of the corpus callosum, which likely relate to seizure activity rather than infarcts.
Caput succedaneum.
Discussion
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References
- Bhat V, Bhat V. Neonatal neurosonography: A pictorial essay. Indian J Radiol Imaging 2014; 24(4): 389-400.
- Moron NF, Morriss M, Jones J, Hunter J. Lumps and bumps on the head in children: use of CT and MR imaging in solving the clinical diagnostic dilemma. Radiographics 2004; 24: 1655-1674.
- Starkey J, Kobayashi N, Numaguchi Y, Moritani T. Cytotoxic lesions of the corpus callosum that show restricted diffusion: mechanisms, causes, and manifestations. Radiographics 2017; 37: 562-576.
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