Neonatal hypoxic ischemic encephalopathy

Case contributed by Dr Rayyan Mardhiyah

Presentation

Term neonate. Normal antenatally. Delivered via emergency cesarean section for failed instrumentation. Apgar score was 6 at 1 minute, and 7 at 5 minutes. 5 episodes of facial flushing with excessive jitteriness accompanied by desaturation.

Patient Data

Age: 8 days

Symmetrical T1W hyperintensities at perirolandic, bilateral putamen and ventrolateral thalamic regions with associated restricted diffusion on DWI/ADC.

Incidental bilateral subdural hemorrhage at both occipital regions which shows T1W hyperintense signal and T2W hypointense signal in keeping with hyperacute bleed. Subdural hemorrhage is not uncommon post-delivery, particularly when traumatic.

Case Discussion

This patient had ultrasound brain examinations ( images not shown) prior to the MRI examinations which shows bilateral symmetrical basal ganglia and thalamic hyperechogenicity.

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