0:00

Okay, vascular lesions.

0:01

So just like in adults, right?

0:02

You can have cortical and medullary vein thrombosis,

0:05

but, uh, neonates are more, uh, predisposed

0:07

to prothrombotic conditions from the birth, from sepsis,

0:11

from hypoxia, ischemia, all of these things.

0:14

So you really wanna make sure

0:15

that this is a high level suspicion.

0:17

'cause uh, I think, I think this case was called trauma, um,

0:21

by an adult radiologist, right?

0:22

And it's like, yes, there is diffuse hypoxia

0:25

and there's a lot of, uh, peripheral,

0:27

but like, I mean, there aren't any subdurals, right?

0:29

And, and it's like, what is this?

0:31

So basically there was diffuse venous sinus thrombosis,

0:34

and then you had secondary arterial.

0:36

Because if you get the impaired venous outflow over

0:39

time, the pressures build up.

0:40

And then you get little petee hemorrhages, right?

0:42

The capillary rupture. And then the pressures get so high

0:46

for venous outflow that you start to get secondary arterial.

0:48

So there's no, you know, arter large artery distribution

0:51

because the entire brain is in farting, right?

0:53

From a longstanding venous thrombosis.

0:55

So very important, uh, to remember this diagnosis.

0:58

And the medullary veins can also be congested and immature.

1:00

And so you can see again, that T one shortening kinda linear

1:03

radiation engorgement thrombosis.

1:05

And so this can also give you kind

1:06

of like a white matter injury like pattern.

1:09

But the key is that you actually have a bunch of, uh,

1:11

congested met veins through that whole area,

1:14

and very linear vein

1:16

and Galen malformations, you know, this, uh,

1:18

essentially AV shunting, high flow shunting, right?

1:21

Uh, through the median presence, pha like vein,

1:23

they can have this turbulent yin yang flow.

1:25

Lots of, you know, choroidal, uh, or mural feeders

1:28

and ischemia of the brain parenchyma,

1:31

and this is a good one to know the collagen four A

1:34

mutations, uh, they can cause, um, neonatal

1:37

or even antenatal, uh, hemorrhagic porn cephalic,

1:40

essentially it's, uh, the collagen four in the vessel walls

1:43

can give you hemorrhagic strokes throughout life, right?

1:45

So if you see like a fetal MRI

1:48

or a neonate with a bunch of like hemorrhagic, you know,

1:50

porn cephalic cysts, right?

1:51

You really have to invoke this diagnosis.