This is a MRI brain of a term neonate who has been classified as moderate Sarnat clinically. T1W (A and B), T2W (C and D), DWI (E), ADC (F). (A and B) Absent myelination [black arrowheads] of the posterior limb of both internal capsules (PLIC), which is better depicted on T1WI (3 + 3). Abnormal signal demonstrated in the caudate nucleus (1 + 1) [white arrows], globus pallidus/putamen (3 + 3) [black arrows], thalamus (2 + 2) [white thin arrows] and cortex (1 + 1) [white arrowheads] on T1WI. Abnormal signal in brainstem (1 + 1) and white matter (1 + 1) (not shown). (C and D) On T2WI, there is presence of PLIC myelination (0 + 0) [black arrowheads]. Normal signal of caudate nucleus (0 + 0) [white arrowheads]. Also noted abnormal signal of globus pallidus/putamen (2 + 2) and thalamus (1 + 1) (not shown). Abnormal signal of brainstem (1 + 1) [white arrows], cerebellum (1 + 1) [white stars] and white matter (2 + 2) [black arrows] on T2WI. (E and F) Restricted diffusion noted at the corpus callosum on DWI and ADC (1 + 1) [black arrows]. Therefore, the total score is 40which is classified as severe HIE. The child has cerebral palsy at 2 years old