Infant who was on arterial-venous ECMO post cardiac arrest and has just been taken off of ECMO

CT of intraventricular hemorrhage, intracerebral hemorrhage, and cerebral atrophy in a patient on extracorporeal membrane oxygenation (ECMO)
Axial CT without contrast of the brain shows mixed-density fluid in the left lateral ventricle posteriorly and mixed-density fluid in the left parietal-occipital lobe. There is also diffuse prominence of the sulci and ventricular system.

The diagnosis was intraventricular hemorrhage on ECMO and intracerebral hemorrhage on ECMO and cerebral atrophy post ECMO.

Newborn with a prenatal diagnosis of hydrocephalus, status post VP shunt placement

CT of over-shunting
Initial axial CT without contrast of the brain (above) showed marked dilation of the lateral, third and fourth ventricles. Axial CT without contrast of the brain 1 day after shunt placement (below) shows interval decompression of the ventricular system and interval development of large bilateral subdural hygromas.

The diagnosis was subdural hygroma development due to over-shunting.

Toddler who is fussy and crying

CT of ventriculoperitoneal shunt malfunction
Axial T2 MRI without contrast of the brain (above) obtained 2 months ago shows normal ventricular size with a VP shunt in place. Axial CT without contrast of the brain (below) shows interval marked dilation of the lateral and third ventricles with transependymal flow of cerebrospinal fluid. The VP shunt series showed no radiographic abnormality of the VP shunt.

The diagnosis was VP shunt malfunction due to occlusion of the VP shunt.

Infant who fell 3 feet out of bed onto a wooden floor

CT of an (not) accessory skull suture
3D reconstruction from CT without contrast of the brain (left) shows a linear straight lucency that connects to the left lambdoid suture. Coronal CT (right) shows the same linear lucency lying under a large subgaleal hematoma.

The diagnosis was a linear skull fracture and not an accessory suture of the skull based on the soft tissue swelling associated with the linear lucency.