fig 3.

Patient 2.

A, Diffusion-weighted image (b = 700 s/mm²) at the level of the basal ganglia performed at age 16 hours shows diffusely reduced diffusion in cortex and deep gray nuclei. On initial evaluation, this image was thought to be normal; however, subsequent analysis revealed a reduction in the ADC of about 15% throughout the brain. The distortion and hyperintensity of the back of the head results from chemical blankets used to keep the body temperature at 37°C.

B, Proton MR spectrum (2000/288) from the thalami and basal ganglia at age 16 hours shows marked reduction of NAA (singlet at 2.01 ppm, indicated by open arrow) and marked elevation of lactate (doublet at 1.33 ppm, indicated by solid arrow).

C, Axial SE (3000/120) image at age 18 hours shows some mildly diffuse T2 prolongation.