Clinical, anatomic imaging, and diffusion (manual interrogation) data
| Patient No. | Age at Scan | Clinical Background | T1-weighted images | T2-weighted images | Diffusion Images (Dav, mm2/s) |
|---|---|---|---|---|---|
| 153a | 2 d (25.5 h) | Placental abruption, deep fetal decelerations and poor variability. | Slight hyperintensity in basal ganglia and at the depths of several cortical sulci. | Diffuse hyperintensity in white matter, basal ganglia | Reduced diffusivity in lateral thalami (0.70), posterior limbs of internal capsules (0.75) |
| Emergent C-section. | |||||
| Seizure at 8 hours, required 3 drugs | Absent hyperintensity in PLIC | ||||
| 153b | 6 d (124 h) | Hyperintensity in dorsal brain stem, posterolateral putamina, lateral thalami | Slight hypointensity in posterolateral putamina and lateral thalami | Reduced diffusivity in posterior thalami (0.80), splenium of corpus callosum (0.80), and left more than right hemispheric white matter | |
| 154a | 2 d (48 h) | Tight nuchal cord, variable decelerations. | Normal | Blurring of cortex and white matter in anterior and posterior watershed zones | Reduced diffusivity in bilateral posterior thalami, anterior and posterior watershed cortex, and subcortical white matter |
| Multifocal seizures at 10 hours, treated with 4 drugs. | |||||
| Negative blood and CSF cultures and PCR | |||||
| 154b | 4 d (91 h) | Normal | Blurring of cortex and white matter in anterior and posterior watershed zones | Reduced diffusion in posterior watershed cortex and white matter | |
| Slight persistent reduced diffusion in anterior watershed cortex | |||||
| Minimal persistent reduced diffusion in posterior thalami | |||||
| 155a | 1 d (20 h) | Oligohydramnios, thick meconium, birth depression. | Normal | Hyperintensity in white matter and thalami | Reduced diffusivity in watershed white matter |
| Seizure on day of life 2, stopped with phenobarbital. | PLIC present | ||||
| Negative blood cultures | |||||
| 155b | 6 d (124 h) | Normal | Subtle gray-to-white blurring in posterior watershed cortex. Increased T2 in white matter and thalami | Reduced diffusivity in watershed white matter | |
| PLIC present | |||||
| 155c | 8 d (170 h) | Hyperintensity in watershed cortex | Hyperintensity in watershed cortex, posterior more than anterior | Normal | |
| 162a | 2 d (46 h) | Maternal hypotension after epidural placement, fetal decelerations, C-sections, thick meconium. Seizures at 8 hours, treated with phenobarbital. Mom had history of herpes, but no lesions at labor, and PCR was negative for viruses in CSF | Slight hyperintensity in VLT, posterior putamen | Normal | Reduced diffusivity in left frontal subcortical white matter (0.50) and cortex, greater than right. Reduced diffusivity in VLT, left more than right (0.60–0.65) |
| Faint hyperintensity in PLIC | |||||
| 162b | 7 d (146 h) | Hyperintensity in left more than right frontal cortex, left GP | Normal | Reduced diffusivity in VLTs only (0.70–0.75) | |
| 163a | 1 d (22 h) | Seizures in utero 3 days before birth. Crash C-section due to flat fetal heart rate. Infant seizing at delivery, nuchal cord1. PCR of CSF was negative | Hyperintensity in GP, putamen, caudate, VLT | Hyperintensity in most of cerebral cortex | Reduced diffusivity in VLTs (0.40), putamina (0.60), PLIC (0.55), subcortical white matter (0.70–0.75), dorsal BS (0.45–0.50) |
| Absent hyperintensity in PLIC | |||||
| 163b | 3 d (64 h) | Hyperintensity in GP, putamen, caudate, VLT, dorsal BS | Hypointensity in dorsal BS, VLT, lateral putamen | Reduced diffusivity in hippocampi (0.45), subcortical white matter (0.45–0.50), basal ganglia (0.45), thalami (0.35), cerebellar vermis (0.50) | |
| Absent T1 in PLIC | Long T2 in remainder of thalamus, much of cortex | ||||
| 167a | 1 d (19 h) | Pre-eclampsia, failed home labor, thick meconium, variable decelerations, crash C-section. After birth, persistent pulmonary hypertension, hypoglycemia, acute tubular necrosis. Blood cultures negative | Increased T1 in VLT | Normal | Tiny area of reduced diffusivity in VLTs (0.85) |
| Normal PLIC | Focal infarct left frontal lobe | ||||
| 167b | 4 d (88 h) | Normal | Slight T2 prolongation in cortical infarcts | Small amount of reduced diffusivity in VLTs (0.60) and CSTs (0.70). Two focal infarcts, left frontal and left occipital | |
| 170a | 2 d (34 h) | Uterine rupture, deep decelerations. | Hypointensity in thalami | Hyperintensity in thalami, basal ganglia | Reduced diffusivity in lateral thalami (0.55), CSTs (0.65), posterior BS (0.65–0.70) |
| Seizures at 9 hours. Blood cultures negative | Normal PLIC | ||||
| 170b | 3 d (61 h) | Hypointensity in basal ganglia | Hyperintensity in thalami, basal ganglia | Reduced diffusivity in putamen more than caudate, anterior and lateral thalami (0.40), CSTs (0.45–0.50), subthalamic nuclei, dorsal BS (0.50) | |
| Hyperintensity not seen in PLIC | |||||
| 178a | 1 d (16 h) | Maternal septic shock. Fetal tachycardia and abnormal fetal tracing. Thick meconium; no spontaneous activity or respirations at birth. Apgars 0, 0, 1 at 1, 5, and 10 minutes. Transient hepatic and renal dysfunction. Seizures before first MR image. Blood and CSF cultures of infant were negative | Hyperintensity in caudate, GP, putamen | Hypointensity in VLT | Reduced diffusivity in VLTs (0.65), CSTs (1.0) |
| Normal PLIC | Blurring of perirolandic cortex | ||||
| 178b | 4 d (83 h) | Hyperintensity in VLT, GP, posterior putamen, posterior insula | Normal | Reduced diffusivity in posterior putamina (0.55), VLTs (0.50), CSTs (0.70–0.75), CC (0.75), subcortical white matter (0.60) | |
| Hyperintensity not seen in PLIC | |||||
| 178c | 7 d (178 h) | Globular hyperintensity in VLTs, GP–putamen junction, posterolateral putamen. Hyperintensity not seen in PLIC | Heterogeneous basal nuclei. T2 prolongation in cerebral white matter | Reduced diffusivity in posterior putamen (0.70). Minimally reduced in VLTs (0.90), CSTs (1.0). | |
| 193a | 2 d (34 h) | Home delivery complicated by LGA infant and shoulder dystocia. After prolonged delivery, infant was cyanotic, limp. Infant was given CPR for 40 minutes before spontaneous respirations. Seizures at about 5 hours, treated with phenobarbital | Hyperintensity in VLTs, GPs, putamina, caudates, most of cerebral cortex. Normal PLIC | Hyperintensity of BG, thalami. Blurring of perirolandic cortex | Reduced diffusivity in VLTs (0.45–0.50), CSTs (0.60) |
| 193b | 7 d (148 h) | Hyperintensity in VLTs, GPs, putamina, caudates, posterior insular cortex, perirolandic cortex, calcarine cortex | Normal | Reduced diffusivity in cingulum (0.65), corpus callosum (0.60), fronto-occipital fasciculus (0.95), optic radiations (0.90), uncinate fasciculus (0.85) | |
| Hyperintensity not seen in PLIC | |||||
| 195a | 2 d (44 h) | Jittery baby. Mild hypoglycemia. Low normal ABG pH | Normal. Hyperintensity present in PLIC | Normal | Normal |
| 195b | 19 d (330 h) | Focus of hyperintensity in right frontal periventricular white matter | Normal | Normal |
Note:—Dav indicates average diffusivity; PLIC, posterior limb of internal capsule; ABG, arterial blood gas; VLT, ventrolateral thalamus; CST, corticospinal tract; GP, globus pallidus; CC, corpus callosum; LGA, large for gestational age; CPR, cardiopulmonary resuscitation; CSF, cerebrospinal fluid; BS, brain stem; PCR, polymerase chain reaction.