Fig. 2

A 20-days-old female patient weighted 2750 gm presented clinically by respiratory distress-Sarnat stage II. Conventional MRI Axial T1WI (A, B) shows rim of high signal intensities (germinal matrix hemorrhage) in the left occipital horn and adjacent to the frontal horn of lateral ventricle (red arrows). Axial T2WI (C) shows dilatation of the ventricular system (black arrow) and dilatation of subarachnoid spaces (central and peripheral atrophic changes) (blue arrows), indistinct grey white matter differentiation (green arrows). Multivoxel MRS (D) and MRS Spectrum (E) long TE 144 show decreased NAA peak, and increased CHO peak also Multivoxel MRS (F) and spectrum (G) short TE 35 show marked increased lac peak. Lac/Cr at basal ganglia & thalamus ratio 2.7 denoting marked stage of HIE (grade III). Outcome: Cerebral palsy