Preterm infant. Perinatal depression. Acidosis and status epilepticus with abnormal background EEG. Status post cooling. Evaluate for hypoxic ischemic encephalopathy. There is abnormal diffusion restriction in a patchy pattern involving the frontal and parietal white matter, which is lightly worse on the left, with relative perirolandic sparing. Similar abnormality is present along the splenium of the corpus callosum and ventrolateral thalami. These areas are associated with mildly increased T1 signal. There is also low ADC/restricted diffusion involving the dorsal pons as well. There is no parenchymal susceptibility effect to indicate intraparenchymal hemorrhage. However, there is T1 hyperintensity on the dorsal surface of the parietal lobes and in the posterior fossa which may represent minimal, extra-axial hemorrhage. There is no midline shift or herniation.There is diffuse scalp soft tissue swelling (caput succedaneum). In addition, there is focal T2 hypointensity (hematoma) in the vertex on the right side which probably represents an associated cephalohematoma. This is 8 mm deep and 29 mm in transverse. There is no underlying displaced skull fracture evident.
Diffusion restriction involving the subcortical white matter of the frontal and parietal lobes, splenium of the corpus callosum, thalami, and dorsal pons. Findings are consistent with extensive hypoxic-ischemic injury.