A 3-Hour-Old Boy Is Being Evaluated in the Newborn Nursery

A 3-hour-old boy is being evaluated in the newborn nursery.  The patient was born via spontaneous vaginal delivery to a 25-year-old woman, gravida 2 para 2.  The mother had no prenatal care and takes no medications.  Head circumference is at the 90th percentile.  Weight is at the 25th percentile.  Temperature is 37.3 C (99.1 F) , pulse is 140/min, and respirations are 32/min.  Per the Ballard Score, the patient is at 38 weeks gestation.  Head examination shows a full fontanelle.  The ears are in the normal position.  The oropharynx is clear.  Cardiopulmonary examination is unremarkable.  The abdomen is soft with no organomegaly.  Examination of the back shows a large myelomeningocele.  Bilateral lower extremities are flaccid.  Head imaging is most likely to reveal which of the following?

A) Arteriovenous malformation at the vein of Galen
B) Choroid plexus overgrowth in the lateral ventricles
C) Diffuse leptomeningeal enhancement
D) Hemorrhage in the germinal matrix
E) Inferior displacement of the medulla and cerebellum

Correct Answer:

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