CT findings in neonatal hypothermia

Area of Science:

• Neonatal neurology
• Pediatric radiology
• Hypothermia research

Background:

• Newborn infants are highly susceptible to hypothermia, a condition associated with significant mortality.
• Hypothermia in neonates can lead to severe neurological complications.

Purpose of the Study:

• To investigate the characteristic computed tomography (CT) brain patterns in infants diagnosed with neonatal hypothermia and presenting with neurological symptoms.
• To identify specific CT findings associated with hypothermia-induced brain injury in newborns.

Main Methods:

• Retrospective review of brain CT scans from nine infants with neonatal hypothermia, multiple organ failure, seizures, and coma.
• Analysis of CT findings, including cerebral edema, grey-white matter density relationships, and thalamic, brainstem, and cerebellar densities.

Main Results:

• Two infants had normal CT scans and recovered fully.
• Seven infants exhibited diffuse cerebral edema with a characteristic 'reversal sign' (altered grey-white matter density, increased thalamic, brainstem, and cerebellar density).
• Six surviving infants with severe developmental delay showed cerebral atrophy and multicystic encephalomalacia on follow-up CT.

Conclusions:

• The 'reversal sign' on CT is a significant indicator of brain injury in neonatal hypothermia.
• This sign has also been observed in cases of child abuse, birth asphyxia, and drowning-related anoxia.
• Neonatal hypothermia should be considered a potential cause of the 'reversal sign' and associated neurological deficits.