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Prenatal Germinal Matrix Hemorrhage
Case Detail
| Anatomy: Brain-Spine |
 Joseph Junewick, MD FACR |
| Diagnostic Category: Vascular |
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| Created: about 1 year ago |
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| Updated: about 1 year ago |
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| Tags:
PEDS
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| Modality/Study Types:
MR
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Activities:  PDF  ImageJA |
History
“Intraventricular” mass on prenatal ultrasound.
Case Images
Diagnosis
Prenatal Germinal Matrix Hemorrhage
Findings
Prenatal MR – Mixed signal lesion at the caudothalamic groove protruding into the lateral ventricle.
Discussion
Hemorrhage usually appears as a hypointense area on T2-weighted images. Intraventricular hemorrhage can appear as debris layering in the dependent portion of the ventricle or as a focal hematoma. The detection of small subependymal hemorrhages is more difficult, partly because the normal germinal matrix has similar signal intensity to blood (hypointense on T2-weighted images and hyperintense on T1-weighted images) because of its high cellularity. Gradient-echo sequences may be useful to help to confirm the presence of blood, because the hemorrhage appears more hypointense than the germinal matrix. Differential diagnosis of signal disturbance at the caudothalamic groove includes infection and tuberous sclerosis.
Reference
Glenna OA, Barkovich AJ. Magnetic Resonance Imaging of the Fetal Brain and Spine: An Increasingly Important Tool in Prenatal Diagnosis, Part 1. Neuroradiology (2006); 27:1604-1611.