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Diagnosis Detective - April 2024

April 1, 2024

Red Book Online Presents: Diagnosis Detective | April 2024

Contributed by Sydney Topfer, MD, Cohen Childrens Medical Center at Northwell Health

A female infant was born at 36 weeks and 6 days gestation to a 37-year-old mother G3P0020 with a history of polycystic ovarian syndrome. Prenatal care in Trinidad and Tobago was normal until 35 weeks. Shortly after birth, a neonatal ultrasound showed  hydrocephalus and severe ventriculomegaly; the infant was admitted to the NICU. The patient was afebrile, normotensive, and oxygen saturations were 100% on room air. The head circumference was in the 79th percentile. The anterior fontanelle was open and flat; the cardiovascular exam was unremarkable; appropriate tone and normal reflexes were present. Chorioretinitis was identified on eye exam. The infant passed the hearing screen. An MRI re-demonstrated ventriculomegaly as well as  intraventricular hemorrhage (IVH) and germinal matrix hemorrhages, leptomeningeal enhancement, and a right parietal ring type lesion measuring 4.9 mm in diameter.

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