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Multifocal Upper Cervical Spine Injury
Joseph Junewick, MD FACR
over 8 years ago
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Newborn HIE

Case Detail

Anatomy: Brain-Spine
Junewick
Joseph Junewick, MD FACR
Diagnostic Category: Vascular
Created: over 6 years ago
Updated: over 6 years ago
Tags: PEDS
Modality/Study Types: MR
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History

Term newborn with perinatal depression.


Case Images


Diagnosis

Newborn HIE

Findings

MR – T1 hyperintensity in thalami and lentiform nuclei with restricted diffusion.

Discussion

Hypoxic-ischemic brain injury depends upon the level of brain maturation at the time of the insult and the severity and duration of the hypoperfusion event. The degree of brain maturation dictates the configuration of the vascular supply as well as the state of regional metabolism in the neonatal brain. In mild to moderate hypoperfusion, cerebral blood flow is redistributed to ensure perfusion to the hypermetabolically active gray matter structures including the basal ganglia, brainstem, and cerebellum; this redistribution results in injury predominantly to the watershed zones of the cerebrum. In severe hypoperfusion, the vulnerable regions include the lateral thalami, posterior putamina, hippocampi, brainstem, corticospinal tracts, and the sensorimotor cortex. On MR images, abnormal T1 hyperintensity is the predominant feature and accompanied by restricted diffusion. Lactate doublet will be seen at 1.4 on MR spectroscopy.

Reference

Chao CP, Zaleski CG, Patton AC. Neonatal Hypoxic-Ischemic Encephalopathy: Multimodality Imaging Findings. RadioGraphics (2006); 26:S159-S172.

Contributor

John Quick, MD



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