Paediatric Neuroimaging, Congenital CNS Malformations, and Hydrocephalus — WACS Viva & Clinical Scenarios (Paediatric Radiology)

Exam-style paediatric neuroimaging, congenital cns malformations, and hydrocephalus viva scenarios with examiner probes and model answers for Radiology…

Scenarios covered

• SCENARIO 1: A 28-week premature infant born weighing 1050 g undergoes routine cranial ultrasonography on day 4 of life in the neonatal intensive care unit. Outline the standard acoustic windows and planes used in neonatal neurosonography, detail the Papile and Volpe grading systems for germinal matrix hemorrhage, and describe the sonographic features of periventricular leukomalacia across its acute, subacute, and chronic stages.
• SCENARIO 2: A term infant with low Apgar scores and clinical hypoxic-ischemic encephalopathy undergoes brain magnetic resonance imaging (MRI) at 4 days of life. Discuss the pathophysiology and imaging findings of acute profound asphyxia versus partial prolonged asphyxia, detail the diagnostic utility and timing of diffusion-weighted imaging and MR spectroscopy, and explain the significance of the posterior limb of the internal capsule (PLIC) sign.
• SCENARIO 3: A 6-month-old infant presents with macrocephaly, delayed developmental milestones, and an enlarging head circumference crossing percentiles. Discuss the neuroimaging approach to distinguish non-communicating (obstructive) hydrocephalus from communicating hydrocephalus, contrast the imaging hallmarks of aqueductal stenosis with benign enlargement of the subarachnoid spaces of infancy (BESS), and state the diagnostic utility of Evans index and fronto-occipital horn ratio.
• SCENARIO 4: A 2-day-old infant is referred for neuroimaging following prenatal ultrasound suspicion of a posterior fossa cystic lesion. Compare and contrast the imaging characteristics of Dandy-Walker malformation, persistent Blake pouch cyst, Joubert syndrome, and mega cisterna magna on ultrasound, CT, and MRI.
• SCENARIO 5: In the evaluation of holoprosencephaly, corpus callosum agenesis, and Chiari malformations: detail the spectrum of holoprosencephaly with key anatomical landmarks; describe the characteristic cross-sectional imaging features of complete agenesis of the corpus callosum; and contrast the craniocervical junction anomalies of Chiari I versus Chiari II malformations.