Purpose or Case Report: The main purpose is to depict sonographic features of the subpial hemorrhage of the neonate. Secondary purposes are: (1) Review the anatomy of the subpial space, (2) Review proposed pathophysiology, (3) Demonstrate CT and MR correlates of subpial hemorrhages.
Methods & Materials: 11 retrospective cases aged from 0 days to 15 days were collected utilizing an electronic database of radiology reports at our academic children's hospital from May 2015 to August 2021. All cases were confirmed with MRI.
Results: Subpial hemorrhages demonstrate these sonographic findings: (1) Peripheral hyper or hypoechogenic mass with lobulated margins. (2) Hyperechogenicity of the underlying cortex, (3) Cortex interposed between the subpial hemorrhage and the white matter, (4) Hyperechogenicty of the underlying white matter ranging from mild edema to large hemorrhagic infarcts, (5) Most common location in the parietal or anterior temporal lobes.
Conclusions: Subpial hemorrhage of the neonate is a poorly recognized type of intracranial hemorrhage on ultrasound, often misdiagnosed as a tumor or intraparenchymal hemorrhage. Subpial hemorrhage can be suspected on ultrasound on the basis of the imaging features we describe.