Radiological Findings in a Neonate with Seizure: Discussion Based Approach

Findings:5 day old full term neonate with seizures . MRI shows non hemorrhagic infarction in anteromedial left thalamus with rest grossly normal for age FAQs1. What is the abnormality?Left thalamus in the antero medial nuclei location shows restricted diffusion with reduced ADC values with no haemorrhage / intraventricular bleed/ midline shift/ herniation with unremarkable PCA flow void/ unremarkable watershed zones 2. How do we interpret this?Radiologically could rep overlap of the two most common aetiologies of hypoglycaemia(anteromedial thalamic nuclei +) and HIE (thalamus is involved in Acute profound variety3. Does the picture suggest " Radiological hypoglycaemia"?No classically it should have been watershed zones involvement in severe hypoglycaemia ORSymmetrical post white matter/ grey matter/ pulvinar and anteromedial thalamic nuclei  to be labelled as Radiological hypoglycaemia 4. What is def of laboratory hypoglycaemia?Appx less than 46mg/dL in radiology literature 5. Is the thalamic haemorrhage different ?Thalamic haemorrhage should point towards deep cerebral venous thrombosis particularly straight sinus with status epilepticus 6. Can we have normal MRI in HIE?Yes they are common7. How do we conclude HIE for routine radiologist ?Four abnormal imaging patterns sump HIE    (a) watershed (b) basal ganglia (c) total, and (d) focal-...
Source: Sumer's Radiology Site - Category: Radiology Authors: Source Type: blogs