Neonatal intracranial hemorrhage (ICH) represents a significant challenge in perinatal neuroimaging due to its variable etiology, presentation, and long-term impact on neurodevelopmental outcomes. This pictorial review aims to provide a comprehensive review of the magnetic resonance imaging (MRI) characteristics of hemorrhagic lesions in the neonatal brain. This includes detailing the appearance and evolution of blood products in neonates, the familiar sites and etiologies of ICH, and how these findings differ between preterm and term infants. The presentation will also address the unique imaging features of hemorrhagic lesions in the immature brain and discuss their neurodevelopmental outcomes. Key objectives include: 1. Explore the typical MRI appearances of blood products at different stages of a neonatal brain hemorrhage.. 2. Analyze the evolution of parenchymal and extra-axial hemorrhages, noting differences in imaging findings based on gestational age. 3. Understand the common causes of neonatal ICH, including perinatal trauma, hypoxic injury, and clotting disorders, and their multifactorial nature. 4. Discuss the neurodevelopmental implications of neonatal ICH, including the potential for impaired outcomes related to the location and size of hemorrhagic lesions. This abstract emphasizes the critical role of early and accurate imaging in diagnosing and managing neonatal hemorrhagic lesions, contributing to improved outcomes in affected infants. Read More

Meeting name: SPR 2025 Annual Meeting , 2025

Authors: Ramegowda Rajath, Prabhu Sanjay

Keywords: Hemorrhage, Neonatal, Brain

Purpose Post-hemorrhagic ventricular dilatation (PHVD) is a common sequela of severe neonatal intraventricular hemorrhage (IVH), often necessitating cerebrospinal fluid (CSF) shunt placement. Despite advances in shunt technology and neonatal neurosurgical care, shunt malfunction remains a leading cause of morbidity and repeat surgical intervention in this population. After reviewing this exhibit, participants will be able to: 1. Describe the pathophysiologic mechanisms and imaging manifestations of shunt failure following neonatal intraventricular hemorrhage. 2. Apply a structured, multimodality diagnostic algorithm integrating ultrasound, MR ventricular check examinations, and rapid MRI techniques for shunt assessment. 3. Recognize imaging considerations for programmable and nonprogrammable shunt valves and identify key features predicting recurrent or multiloculated hydrocephalus. Content Organization - Pathophysiologic mechanisms unique to the post-IVH brain—including septations and ependymal scarring, predispose to both mechanical and functional shunt failure. Common causes include proximal or distal obstruction, valve dysfunction, and secondary complications such as infection or pseudocyst formation. - Multimodality examples (ultrasound, MRI, CT) are used to illustrate key imaging findings and subtle differentiating features. - A stepwise diagnostic algorithm is presented, beginning with cranial ultrasound in newborns and younger infants, followed by rapid-sequence MRI (single-shot T2, 3D DRIVE/CISS) for ventricular morphology and catheter assessment, with CT reserved for problem solving. Phase-contrast MRI assists in evaluating CSF flow and shunt patency. - Programmable and non-programmable shunt valves are reviewed, highlighting imaging appearance, verification techniques, and implications for longitudinal surveillance. Recommended imaging intervals and markers of evolving multiloculated hydrocephalus are summarized. Conclusion Early, accurate recognition of shunt malfunction after neonatal IVH depends on understanding its imaging signatures and etiologies. This exhibit provides a step-by-step, multimodality algorithm, anchored in rapid MRI vent checks and informed by shunt hardware variability with illustrative cases to guide pediatric radiologists in assessment and follow-up, and to support coordinated care with neurosurgery and neonatology. Read More

Meeting name: IPR 2026 Congress , 2026

Authors: Sahu Asutosh, Prabhu Sanjay

Keywords: Intracranial Hemorrhage, Shunts

Background: The germinal matrix (GM) is a transient, highly vascular zone that involutes between 24–34 weeks’ postmenstrual age. In extremely preterm infants (≈22–28 weeks), maturational changes in size, echogenicity, and symmetry can mimic or mask hemorrhage, leading to grading variability and inconsistent follow-up. Purpose: To present a developmentally tuned, imaging atlas enabling radiologists to distinguish physiologic GM maturation from germinal matrix hemorrhage (GMH) using standardized cranial ultrasound (US) and MRI techniques and terminology. Educational Objectives 1. Summarize GM anatomy, vascular “hot spots,” and week-by-week involution. 2. Standardize US across anterior, posterior, and mastoid windows for optimal assessment of the caudothalamic groove and posterior fossa. 3. Specify age-related normal variants vs hemorrhage on US and MRI (T1/T2, SWI, DWI), with key sequence-specific pitfalls. 4. Provide a concise measurement/reporting lexicon to improve reproducibility and inter-reader agreement. Content Highlights: - Anatomy & Maturation Map: Caudothalamic groove, subependymal region, ganglionic eminence; gestational-week echogenicity charts. - Acquisition Essentials: Minimal-variance US (required planes, cine sweeps, gain/depth); a 12–15-minute, sedation-sparing MRI set (3D T2, axial T2/T1, DWI/ADC, SWI) with neonatal parameter tips. - US Pattern Library: Early symmetric subependymal echogenicity; benign choroid plexus prominence; venous plexus near the foramen of Monro; beam-angle/anisotropy effects that simulate clot. - MRI Pattern Library: Age-appropriate T1/T2 at the caudothalamic notch; SWI venous blooming vs microbleed; diffusion pitfalls along the ventricular wall. - Mimics & Traps: Choroid plexus lobulations, mineralizing vasculopathy speckles, dependent ventricular debris, partial-volume at the groove, posterior fossa venous plexus on mastoid views. - Consistency Toolkit: Correct caliper placement for ventricular indices; elements (location, side, extent, confidence). Conclusion Germinal matrix appearance is gestation-dependent; interpretations must be age-calibrated. Meticulous acquisition, appropriate window selection and optimized probe technique, including routine posterior/mastoid views reduces posterior fossa misses. Sequence-aware MRI reading (3D T2, SWI, DWI) limits venous and anisotropy misclassification. Standardized terminology and measurements improve report clarity, interobserver agreement, and reliability of follow-up imaging. Read More

Meeting name: IPR 2026 Congress , 2026

Authors: Sahu Asutosh, Prabhu Sanjay

Keywords: Intracranial Hemorrhage, Ultrasound and MRI

To illustrate the developmental, genetic, and imaging spectrum of malformations of cortical development (MCD) from fetal life through adolescence by integrating principles of normal corticogenesis, key genetic pathways, and evolving MRI patterns. This exhibit emphasizes: 1. Normal neuronal proliferation, migration, and post-migrational organization. 2. Developmental stage–specific MRI features linked to corresponding disruptions in these processes. 3. Major molecular pathways (LIS1/DCX, TUBB2B, MCPH1, CDK6, PIK3, PTEN, HEPACAM, mTOR) associated with characteristic imaging phenotypes. 4. The role of longitudinal imaging in evaluating cortical maturation, prognosis, and presurgical planning. Read More

Meeting name: IPR 2026 Congress , 2026

Authors: Sahu Asutosh, Tripathy Priyadarshini, Kandemirli Sedat, Prabhu Sanjay

Keywords: Magnetic Resonance Imaging, Genetics, Epilepsy

Purpose: Created in 2011, WFPI has spent the last 5 years overcoming geographic, temporal, cultural and linguistic distances to define its added value in the global imaging arena. Have the efforts been worth it? Read More

Meeting name: IPR 2016 Conjoint Meeting & Exhibition , 2016

Authors: Dehaye Amanda, Silva Cicero, Darge Kassa, Prabhu Sanjay, Andronikou Savvas, Laya Bernard, Coley Brian, Boechat Ines

Keywords: World Federation of Pediatric Imaging, Global Pediatric Imaging, International Collaboration