Neuroimaging: hypoxic-ischaemic injury in a term neonate: practice question

A Radiology question in the style of the NEET PG paper. Answer it first, then read why the right option is right and why each of the others is wrong.

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Radiology · Neuroimaging: hypoxic-ischaemic injury in a term neonate

Sample item

A term neonate with severe perinatal asphyxia has seizures. MRI on day 5 shows bilateral signal abnormality in the ventrolateral thalami, posterior putamina and perirolandic cortex. What pattern is this?

Original practice item, not a recalled exam question. Nothing here is recorded.

The answer and the reasoning

B. Acute profound hypoxic-ischaemic injury of the basal ganglia and thalami

Profound, abrupt hypoxia in the term brain injures the metabolically active areas, namely the ventrolateral thalami, putamina, brainstem and perirolandic cortex. Prolonged partial hypoxia instead causes watershed cortical injury.

Option by option

  • A. Kernicterus

    Kernicterus affects the globus pallidus.

  • B. Acute profound hypoxic-ischaemic injury of the basal ganglia and thalami (correct)

    Correct. This deep grey nuclei pattern follows acute profound asphyxia.

  • C. Periventricular leukomalacia

    PVL is typical of preterm infants.

  • D. Watershed injury only

    Watershed injury affects parasagittal cortex and white matter after partial hypoxia.

Source note: Original NextPrep sample item — pending expert review. This item is original practice material awaiting independent expert review, so confirm important facts in a standard textbook.

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Questions about this Radiology question

What is the answer to this Radiology question?

The best answer is B, Acute profound hypoxic-ischaemic injury of the basal ganglia and thalami. Profound, abrupt hypoxia in the term brain injures the metabolically active areas, namely the ventrolateral thalami, putamina, brainstem and perirolandic cortex.

Why is "Kernicterus" not the answer?

Kernicterus affects the globus pallidus.

Why is "Periventricular leukomalacia" not the answer?

PVL is typical of preterm infants.

Why is "Watershed injury only" not the answer?

Watershed injury affects parasagittal cortex and white matter after partial hypoxia.

What concept does this question test?

It tests Neuroimaging: hypoxic-ischaemic injury in a term neonate in Radiology. Prolonged partial hypoxia instead causes watershed cortical injury.

How hard is this question?

We tag it as a multi-step question: it asks you to combine more than one idea. The tag is our own editorial judgement, not an official difficulty rating, so read the reason for every option, not only the answer.

How should I study Neuroimaging: hypoxic-ischaemic injury in a term neonate?

Learn signs with the image, and the disease they point to. Then use the flashcards and the other Radiology questions on this site to test what stuck.

Is this a real NEET PG question?

No. It is an original practice item (editorial status: sample, version 1). NextPrep does not publish recalled or leaked questions, and independent faculty review of this item has not been completed yet, so confirm important facts in a standard textbook.