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Idiopathic Neonatal Subpial Hemorrhage with Underlying Cerebral Infarct: Imaging Features and Clinical Outcome
Z Assis1,2, A Kirton1,3, A Pauranik1,2
1From the Departments of Radiology (Z.A., A.K., A.P., X.-C.W.).
AJNR. American Journal of Neuroradiology
|November 20, 2020
Summary
Neonatal subpial hemorrhage with underlying cerebral infarct has distinct MR imaging and ultrasound features. Early recognition of this condition can improve understanding of risk factors and outcomes in neonates.
Area of Science:
- Neonatal neurology
- Pediatric radiology
- Neuroimaging
Background:
- Neonatal subpial hemorrhage with underlying cerebral infarct is a poorly understood clinicoradiographic syndrome.
- Characterizing its imaging features and outcomes is crucial, especially in preterm neonates.
Purpose of the Study:
- To characterize cranial ultrasound and MR imaging findings of neonatal subpial hemorrhage with underlying cerebral infarct.
- To evaluate associated outcomes across various gestational ages, including extremely preterm infants.
Main Methods:
- Retrospective case series of 16 neonates with subpial hemorrhage and cerebral infarct.
- Review of brain MR imaging and cranial ultrasound by blinded neuroradiologists.
- Abstraction of clinical data and outcomes at >12 months.
Main Results:
- A distinct MR imaging pattern (yin-yang symbol) was observed in neonates.
- Cranial ultrasound detected 6 of 7 MR imaging lesions, correlating well with MR findings.
- 3 extremely preterm neonates did not survive; others had mild neurologic deficits.
Conclusions:
- Neonatal subpial hemorrhage with underlying infarction is recognizable by unique MR imaging and sonographic features.
- Improved recognition may enhance understanding of risk factors and outcomes.
