AJDRAJNR - American Journal of Neuroradiology

Published ahead of print on April 3, 2008
doi: 10.3174/ajnr.A1004
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Prevalence and Evolution of Intracranial Hemorrhage in Asymptomatic Term Infants

V.J. Rooksa,c, J.P. Eatona,e, L. Ruessa,c,d, G.W. Petermanna,c, J. Keck-Wherleyb and R.C. Pedersenb,d

a Department of Radiology, Tripler Army Medical Center Honolulu, Hawaii
b Department of Pediatrics, Tripler Army Medical Center Honolulu, Hawaii
c Department of Radiology and Radiological Sciences, F. Edward Hebert School of Medicine, Uniform Services University of the Health Sciences, Bethesda, Md
d Department of Pediatrics, F. Edward Hebert School of Medicine, Uniform Services University of the Health Sciences, Bethesda, Md
e Weed Army Community Hospital, Fort Irwin, Calif


Figure 1
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  		Fig 1. Posterior fossa SDH in a neonate delivered via SVD. A, Axial MPGR at <72 hours of life demonstrates lobular symmetric low signal intensity with blooming in the posterior fossa (arrows). B, Follow-up T1 images show high-signal-intensity SDH (arrowheads) by 7 days.


Figure 2
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  		Fig 2. Neonate delivered via SVD with both supratentorial and infratentorial SDH. A and B, Initial examination shows the lobular occipital SDH to be very low signal intensity on MPGR (arrows, A) and isointense to gray matter and difficult to detect on the SE T1-weighted MR image (B). C and D, Five-day follow-up shows high T1 SDH (arrowheads) in 2 locations in 2 planes, axial supratentorial (C) and coronal, both supra- and infratentorial (D). E and F, Two-week follow-up shows complete resolution of hemorrhage on T1 images.


Figure 3
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  		Fig 3. Neonate delivered via SVD with posterior fossa SDH seen on US and confirmed on MR imaging. A, Axial sonogram of the posterior fossa through the mastoid fontanel demonstrates initial curvilinear echogenic focus adjacent to the transverse sinus (arrow). B, Axial T1-weighted MR image confirms high-signal-intensity posterior fossa SDH (arrowhead) on day 7 of life.


Figure 4
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  		Fig 4. Images obtained at 7 and 26 days postnatal age for follow-up of bilateral occipital SDH in a neonate with extra-axial collections. Axial T2, T1, gradient-refocused echo (GRE), and FLAIR images (left to right, top row) show CSF-intensity frontal subarachnoid collections that were present since birth. Also note a thin linear T1 hyperintense GRE hypointense bilateral posterior occipital SDH. At 26 days postnatal age (bottom row), left frontal subdural collections that do not conform to CSF signal intensity are present, consistent with spontaneous SDH. The patient had no history of trauma and had a negative evaluation for NAI.





Copyright © 2009 by the American Society of Neuroradiology. Print ISSN: 0195-6108 Online ISSN: 1936-959X