Case Notes
History
Newborn male presenting with heart failureExam
Prior Study
noneDicom
Findings
| MR findings | Correct Answer | Your Answer |
|---|---|---|
|
There is evidence of acute or subacute parenchymal (intraaxial) hemorrhage. |
No | NA |
|
There is evidence of concurrent intraaxial hematoma and subarachnoid hemorrhage (r/o aneurysm/sentinel bleed). |
No | NA |
|
There is evidence of a pial, or choroidal, or deep parenchymal AVM (consisting of afferent arterial input, AVM nidus, and efferent egress veins). |
No | NA |
|
There is evidence of an AVM with a component of higher flow AV fistula within the nidus. |
No | NA |
|
There is evidence of parenchymal angiomatous transformation (AVM variant). |
No | NA |
|
There is evidence of intra ventricular bleeding possibly from choroidal AVM. |
No | NA |
|
There is evidence of a recently thrombosed AVM (perilesional edema). |
No | NA |
|
There is evidence of a primary, intradual, AVF (consisting of afferent or efferent vessels but no nidus). |
Yes | NA |
|
There is evidence of parenchymal hemosiderin deposition from chronic microhemorrhage caused by vascular steal effects produced by either a high flow AVF or AVM. |
Yes | NA |
|
There is evidence of encephalomalacia or leukomalacia related to chronic vascular steal effects or injury related to hemorrhage. |
Yes | NA |
|
There is evidence of rerouting of the venous efferents related to direct AV-shunt, venous-pressure-increase effects. |
No | NA |
|
There is evidence of rerouting of the venous efferents from concurrent venous or dural thrombosis. |
No | NA |
|
There is evidence of marked venous efferent dilatation or venous aneurysm related to the high flow across the AV shunt. |
Yes | NA |
|
There is evidence of focal enlargement of dural sinuses possibly with enlarged orbital veins (often with proptosis) to suggest dural AV fistula or extradural AV fistula of carotid origin. |
No | NA |
|
There is evidence of unexplained pial veins suggesting dural AV fistula. |
No | NA |
|
There is evidence of hemorrhage associated with cortical vein or dural sinus thrombosis. |
No | NA |
|
There is evidence of bleeding near falx (possibly post traumatic in origin - search for brain contusion). |
No | NA |
|
There are the features of enlarge lenticulostriate arteries in the basal ganglia as evidence of Moya-Moya vasculopathy. |
No | NA |
|
There is evidence of multicentric bleeding sites for coagulopathy as cause for bleeding. |
No | NA |
|
There is evidence of focal cytogenic edema for intercurrent hemorrhagic stroke. |
No | NA |
|
There is evidence of hemorrhagic met or other tumor as basis for intracranial hemorrhage. |
No | NA |
|
There is evidence of intercurrent hydrocephalus or herniation syndromes. |
No | NA |
|
There is evidence of a cavernous angioma or multiple consistent with familial cavernous angiomatous syndrome. |
No | NA |
|
There is evidence of non-shunting, cavernous malformation(s). |
No | NA |
|
There is evidence of a DVA. |
No | NA |
|
There is evidence of concurrent DVA + cavernous malformation. |
No | NA |
|
There is evidence of pontine telangiectasia. |
No | NA |
|
Other abnormalities. |
No | NA |
Impression
Expert Answer
Heart failure is a common presentation of a neonatal high-flow pial AV fistulae.
Your Answer
Recommendations & Acuity
Recommendations
Expert Answer
Proceed with additional MR imaging sequences.
Your Answer
Acuity
Expert Answer
Emergent (Action Necessary now)