More articles from Pediatric Neuroimaging

The authors aimed to identify brain MR imaging characteristics obtained from fetal and early neonatal scans that can predict the clinical presentation. A total of 32 neonatal patients (21 patients in the neonatal at-risk cohort, 11 in the infantile treatment cohort) were identified. Maximal mediolateral diameter and cross-sectional area at the narrowest point of the straight/falcine sinus were most predictive of clinical evolution into the neonatal at-risk cohort. This measurement clearly and unambiguously differentiated between high- and low-risk cohorts. The ability to accurately predict clinical evolution after birth based on fetal MR imaging can be of help for both caregivers and families, enabling better preparedness for urgent treatment and better planning for allocation of resources.

Focal signal abnormalities at the depth of the cerebellar fissures in children have been reported and hypothesized to represent a novel pattern of bottom-of-fissure dysplasia. The authors report a series of 23 patients with a similar distribution and appearance of cerebellar signal abnormality attributable to watershed injury. T2 prolongation was observed at the depths of the cerebellar fissures bilaterally in all 23 patients, centered at the expected location of the deep cerebellar vascular borderzone. Diffusion restriction was associated with MR imaging performed during acute injury in 13/16 patients. Five of 23 patients had prior imaging, all demonstrating a normal cerebellum. The etiology of injury was hypoxic-ischemic injury in 17/23 patients, posterior reversible encephalopathy syndrome in 3/23 patients, and indeterminate in 3/23 patients.