Germinal matrix hemorrhage

Case contributed by Heba Abdelmonem
Diagnosis almost certain

Presentation

Preterm labor 32 weeks with severe respiratory distress sent for emergency MRI.

Patient Data

Age: 10 days
Gender: Male
mri

T1WI and T2WI demonstrate abnormal SI of late sub acute blood at the right subependymal region and occipital horn of left lateral ventricle. Left parietal intracerebral hematoma with SI corresponds to late subacute blood is noted as well.

Dilatation of the supratentorial ventricular system. Posterior fossa cyst.

Loss of the signal void character of the superior sagittal sinus as well as both transverse sinuses.

Case Discussion

10 day old baby with history of preterm labor presented with respiratory distress and convulsions, once stabilized sent for emergency MR sequences. The baby was in a very bad clinical condition, and only T1 and T2 axial planes were obtained before the patient became dyspneic and had a seizure that required transfer back to the ICU.

MRI findings suggest a grade IV germinal matrix hemorrhage. Unfortunately the patient did not survive; there is a 90% mortality rate in grade IV germinal matrix hemorrhages. 

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