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This is a retrospective study of neonates who underwent MRI for suspected subpial hemorrhage. Patterns of subpial hemorrhage, medullary vein engorgement/thrombosis, and demographic, clinical, and imaging findings were assessed. Subpial hemorrhage with cortical injury and intraparenchymal hemorrhage was associated with delayed motor development, while subpial hemorrhage with cortical injury was associated with near-normal motor development. Concurrent superficial and deep medullary vessels may indicate a higher risk of poor neurologic outcomes.