Deep Medullary Vein Thrombosis in a Neonate: A Peculiar MRI Pattern

A full-term 15-day-old neonate, without perinatal complications and with a normal Apgar score (10) at 1 and 5 minutes, had difficulty breastfeeding and weight loss (25%) in the first week. She presented encephalopathy, hypernatremic dehydration (sodium 154 mEq/L), acute renal failure (creatinine 1.9 mg/dL), and hypoglycemia (glucose 42 mg/dL). Newborn metabolic screening was negative. MRI brain showed hemorrhage in the cerebral white matter (WM), with right predominance, in addition to subcortical WM and corpus callosum restricted diffusion, related to ischemia (figure). The radiating fan-shaped hemorrhages are compatible with deep medullary vein thrombosis.1,2

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