Imaging Patterns of Neonatal Subpial Hemorrhage – Provisional Statements on Neurological Outcomes

• DOI: 10.3174/ajnr.a8702
• Publication Date: 2025-02-14T15:55:20Z
• Authors: Santiago Martinez...; Patricia P. Rafful; Karen I. Ramirez-...; Angela N. Viaene; Lauren A. Beslow; Sonika Agarwal; Matthew T. Whitehead; Arastoo Vossough; Sara Reis Teixeira

<h3>ABSTRACT</h3> <h3>BACKGROUND AND PURPOSE:</h3> Subpial hemorrhage is an underrecognized type of hemorrhagic stroke primarily affecting neonates. Blood accumulation in the impermeable pia mater compresses adjacent cortex, leading to injury. The consequences this remain poorly understood. study aims evaluate association between imaging findings and neurological outcomes at follow-up neonates with subpial hemorrhage. <h3>MATERIALS METHODS:</h3> We retrospectively included suspected who underwent brain MRI January 2012 February 2024. Two pediatric neuroradiologists evaluated MRIs for location, size, pattern using a previously described system that classified only (Pattern A), cortical injury B), intraparenchymal C). They also assessed medullary vein engorgement/thrombosis. extracted demographic data, perinatal events, hospital outcomes, Alberta Infant Motor Scale (AIMS) scores, when available. Descriptive analysis was used demographic, clinical, findings. Fisher9s exact test associations clinical <h3>RESULTS:</h3> Twenty-nine patients (median gestational age 38 weeks, IQR: 37-39) were included, 82% having birthweights &gt;2500g. hemorrhages most commonly on right side (66%) temporal lobe (62%). Most measured 1-4 cm (59%). Pattern C (15/29, 52%) associated delayed motor development as by AIMS (9/15, 60%) (p=.042), while B (10/29, 35%) near-normal (6/15, 40%) (p=.044). There no statistically significant concurrent superficial deep engorgement/thrombosis presence any deficit (p=.055). <h3>CONCLUSIONS:</h3> patterns particularly development, may have important prognostic management implications. In our cohort, significantly development. Concurrent involvement vessels indicate higher risk poor outcomes. These highlight importance early intervention monitoring presenting ABBREVIATIONS: AIMS= Scale; IQR= Interquartile Ranges; NICU= Neonatal Intensive Care Unit; SD= Standard Deviations.