Pictorial Review

Mimickers of hypoxic-ischaemic brain injury in term neonates: What the radiologist should know

Shalendra K. Misser, Moherndran Archary
South African Journal of Radiology | Vol 28, No 1 | a2810 | DOI: https://doi.org/10.4102/sajr.v28i1.2810 | © 2024 Shalendra K. Misser, Moherndran Archary | This work is licensed under CC Attribution 4.0
Submitted: 03 November 2023 | Published: 29 February 2024

About the author(s)

Shalendra K. Misser, Faculty of Radiology, Lake Smith and Partners Inc., Durban, South Africa; and Department of Radiology, Faculty of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa
Moherndran Archary, Department of Pediatrics, Faculty of Health Sciences, Nelson R Mandela School of Medicine, University of KwaZulu-Natal, Durban, South Africa


Patterns of neonatal hypoxic-ischaemic brain injury (HIBI) are fairly well known. There are, however, other diagnoses with imaging patterns that may mimic HIBI. A review of MRI studies was conducted for children with suspected cerebral palsy, correlated with prior imaging, clinical details and laboratory tests where available. In the 63 identified cases, imaging features were, in many cases, very similar to the known patterns of HIBI. The alternative diagnoses can be classified as developmental, vascular, chromosomal, infections, metabolic disorders, and congenital syndromes. These findings are described in this pictorial essay. The potential mimickers of HIBI described in this essay can demonstrate similar imaging appearances to HIBI.

Contribution: There are multiple possible causes of neonatal encephalopathy other than hypoxic-ischaemic encephalopathy. Many conditions may mimic HIBI, each of which can be associated with significant morbidity. It is prudent for the reporting radiologist to be aware of these alternate clinico-radiological diagnoses.


hypoxic-ischaemic; cerebral palsy; term neonatal; magnetic resonance imaging; neurometabolic


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Crossref Citations

1. Newborns' MicroRNA Expression as Potential Biomarkers for Disease Diagnosis
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International Journal of Neonatology  vol: 1  issue: 1  first page: 22  year: 2024  
doi: 10.14302/issn.2998-4785.ijne-24-5138