Progressive fetal intracranial lesion Teaching NeuroImages Neurology Resident and Fellow Section © 2015 American Academy of Neurology.

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Progressive fetal intracranial lesion Teaching NeuroImages Neurology Resident and Fellow Section © 2015 American Academy of Neurology

Mrs. S 27 year old, primigravida Normal antenatal scan at 35 weeks USG at 36 weeks gestation – Unilateral echogenic lesion in fetal brain – Intracerebral bleed? – Neoplastic mass? Konanki et al Vignette © 2015 American Academy of Neurology

Baby day 1 (37 weeks gestation) Multiple seizures and encephalopathy baby died 3 days later due to continuing seizures and raised intracranial pressure Prothrombotic work-up revealed anti-thrombin III deficiency Konanki et al Vignette © 2015 American Academy of Neurology

Imaging Konanki et al © 2015 American Academy of Neurology

Imaging Konanki et al © 2015 American Academy of Neurology

Fetal Deep Medullary Vein Thrombosis Presenting as Progressive Intracerebral Haemorrhage MRI characteristic of deep medullary vein (DMV) thrombosis with secondary hemorrhagic infarction Radiating “fan-shaped” hemorrhages are unique imaging findings of DMV thrombosis Neonatal/perinatal DMV thrombosis is a rare form perinatal stroke with significant mortality and morbidity Konanki et al © 2015 American Academy of Neurology