Subpial Hemorrhage in Neonates: What Radiologists Need to Know

AJR Am J Roentgenol. 2021 Apr;216(4):1056-1065. doi: 10.2214/AJR.20.22999. Epub 2021 Feb 10.


OBJECTIVE. Subpial hemorrhages, typically seen in neonates, are rare but can harm the adjacent brain parenchyma. The purpose of this review is to summarize the anatomy and pathophysiology of subpial hemorrhage and highlight its characteristic neuro-imaging pattern. CONCLUSION. The distinctive neuroimaging pattern of subpial hemorrhage is best appreciated on brain MRI, which shows the morphology over the cortex and injury to adjacent cortex and subcortical white matter. These findings do not occur in subarachnoid and subdural hemorrhages. Recognizing the pattern of subpial hemorrhages should guide prognostic precision, prognostication, and counseling.

Keywords: MRI; neonate; neuroimaging; subpial hemorrhage.

Publication types

  • Review

MeSH terms

  • Brain / diagnostic imaging
  • Humans
  • Infant
  • Infant, Newborn
  • Infant, Newborn, Diseases / diagnostic imaging*
  • Infant, Newborn, Diseases / physiopathology
  • Magnetic Resonance Imaging
  • Neuroimaging
  • Pia Mater / diagnostic imaging
  • Risk Factors
  • Subarachnoid Hemorrhage / diagnostic imaging*
  • Subarachnoid Hemorrhage / physiopathology
  • Tomography, X-Ray Computed