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.

Materials And 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.