A male infant weighing 2700 g was born by cesarean section at 35 weeks' gestation to a 31-year-old gravida 6 para 5 mother who had an uncomplicated pregnancy.
At birth the infant was cyanotic and dysmorphic. An initial chest roentgenogram (Fig 1) and an echocardiogram were obtained. Echocardiography showed a dilated right atrium and biventricular enlargement with a large right-to-left ductal shunt.
Despite intense medical therapy, the infant's level of oxygenation deteriorated. In anticipation of beginning extracorporeal membrane oxygenation therapy, cranial ultrasonography was performed (Fig 2). Following ultrasonography a skull series was obtained (Fig 3).
Despite aggressive treatment the patient's condition worsened. Attempts at cardiopulmonary resuscitation provided only temporary improvement and he died within several hours.
The Editors welcome contributions to Picture of the Month and Radiological Case of the Month. Those who wish to contribute should send their manuscripts to Dr Feingold (Picture of the Month), National Birth Defects
Mehall CJ, Amundson GM, Wood BP. Radiological Cases of the Month. Am J Dis Child. 1990;144(1):95-96. doi:10.1001/archpedi.1990.02150250105044