The other 5 patients died following a decision to redirect care due to the expected serious long-term sequelae, based on clinical parameters (e.g. therapy-resistant convulsions) and/or extensive cerebral damage documented by MRI. The de-ceased patients had a significantly higher need for respi-ratory and circulatory support compared to the living pa-tients, but there was no difference in the presence of sei-zure activity. Imaging was performed in 25 patients between day 2 and day 8 after birth (median: day 6). Five of the patients died, and MRI imaging was performed post-mortem in 3 of the patients. DWI images were available for 18 infants imaged during life. The clinical characteristics of infants with an MRI were not significantly different compared to the total study population. In 3 deceased patients, MRI imaging was obtained c d post-mortem. In 1 deceased patient, DWI (MRI obtained during life on day 6) showed few abnormalities in con- Fig. 1. MRI imaging. a, b MRI day 7: term born male with Apgar trast to the conventional images that were clearly abnor- scores 5 and 6 at 1 and 5 min and an initial Hb concentration of mal, possibly due to antenatal onset of the anaemia. 1.9 mmol/l [axial T2-weighted image at the level of the basal nuclei (a); axial DWI (b)]. Mild abnormalities in occipital white matter, White Matter Injury not seen as increased signal intensity on DWI. The patient did not come to the follow-up appointments, but had a favourable out-In 16 of the 25 patients (64%), some form of white matter come according to the general practitioner at the age of 2 years.After injury was found, both in surviving and deceased pa- c, d MRI day 2: term born female, Apgar scores 4 and 8 at 1 and 5 Neurodevelopmental test results were available in 20 of the 31 surviving patients (median age: 19 months, range: 14–35). The mean Z-score for neurodevelop-ment was 0.43 (SD 0.71). Only 1 patient (5%) was mild-ly delayed (Z-score: –1.08). The mean Z-score for mo-tor outcome was 0.58 (SD 0.81). One patient (5%) was mildly delayed (Z-score: –1.10). Unilateral spastic cere-bral palsy was diagnosed in 1 patient with haemor-rhagic cortical infarction. Of the 11 patients who were not formally tested, information was retrieved from the paediatrician, general practitioner or the parents. Cere-bral palsy was not diagnosed in any of these patients, but behavioural problems were reported in 1 patient. Information about outcome could not be retrieved in 2 patients. Thirteen of the 20 survivors with available MRI data were tested. The median age of testing was 24 months (range: 15–35). The mean Z-score for neurodevelopment