Q:

A 3-month-precious baby of a keen and highly educated family presented with history of URTl followed by deterioration of level of consciousness and seizure

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 A 3-month-precious baby of a keen and highly educated family presented with history of URTl followed by deterioration of level of consciousness and seizure. CT brain shows intracranial bleeding with no evidence of skull fracture. Fundocscopy was normal. Mother gives history of difficult labour but with normal development, mild hypotonia, and macrocephaly which was reassured initially by general Pediatrician. Of the following, the MOST likely diagnosis is


  1. residual birth trauma
  2. arteriovenous malformation
  3. acute viral encephalitis
  4. glutaric aciduria type 1
  5. abusive head trauma (AHT)

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(D).Patientswith birth trauma may have asymptomatic subdural hematoma which may resolve by the end of first monthof life. Arteriovenous malformation usually has subarachnoid hemorrhage. Encephalitis is possibility but unusually present with lntracraniai bleed.AHT isa possibility but presence of hypotonia and macrocephaly and absenceof retinal hemorrhage make the diagnosis of Giutaric aciduria type 1 is the most likely one

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