CT findings in neonatal hypothermia.

BACKGROUND

Newborn infants are particularly prone to hypothermia, a condition with a high mortality.

OBJECTIVE

To study the CT brain patterns in infants with hypothermia and neurological symptoms.

METHODS

We reviewed the brain CT of nine infants with neonatal hypothermia, multiple organ failure, seizures and coma.

RESULTS

Two infants had normal CT scans, acutely and at follow-up, and were clinically normal at follow-up. In seven infants, CT showed diffuse cerebral oedema, with reversal of the normal density relationship between grey and white matter and a relative increased density of the thalami, brainstem and cerebellum - the 'reversal sign'. In six surviving infants with severe developmental delay, follow-up CT revealed cerebral atrophy with multicystic encephalomalacia.

CONCLUSIONS

The 'reversal sign' has been described in the abused child, birth asphyxia and anoxia due to drowning. Neonatal hypothermia is offered as a further cause.