Contributed by
SUNY Upstate Medical University
Rasika Baraskar, Katarina Hayes, Amin Khan, Saurabh Gupta, and Alka Gupta.
History
6-week-old full-term and immunized female with recently diagnosed milk protein allergy presenting with lethargy, recurrent emesis, poor oral intake, decreased urine output, bloody stools, and a new onset high pitched cry.
Images (Click any image to enlarge)
Lobular and expanded mass like area of hyper-echogenicity within the region of the left caudate nucleus. This area of hyper-echogenicity extends into the lateral ventricle and third ventricle.
Areas of increased DWI signal seen in the bilateral caudate nuclei, left thalamus, and left periventricular white matter adjacent to the left frontal and occipital horn.
Heterogenous signal and ectasia of the left transverse sinus with extension into the confluence of the sinuses seen on the T1 weighted images, along with asymmetrically decreased SWI signal.
Markedly decreased SWI signal within the bilateral ventricles and decreased signal within the bilateral subependymal & deep medullary veins (predominantly on the left).
Question
What is the most likely diagnosis?
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