Week 10 image

What's your diagnosis?

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Answer: Intracranial hemorrhage. A, Magnetic resonance venogram (MRV) of a vein of Galen malformation with widely dilated venous system. B, T1 image with subdural hemorrhage (SDH) shown in the right occipital lobe (see arrow). C, SDH in the posterior fossa (see arrows). Image D reveals a small left-sided intraparenchymal hemorrhage (IPH) caused by a presumed cortical vein thrombosis that is characteristically hyperintense on T1. Image E shows this same hemorrhage with blooming artifact on a susceptibility-weighted image (SWI). Finally, image F shows a massive left-sided IPH (blood is dark on SWI) with midline shift, leading ultimately to herniation in this unfortunate neonate.

Source: Stevenson DK, Cohen RS, Sunshine P. Neonatology: Clinical Practice and Procedures. New York, NY: McGraw-Hill Education; 2015.