1/26. Neonatal brain tissue embolism in the lung.A brain tissue embolus was observed in a major pulmonary artery in the right lung, in a neonate who died from intracranial haemorhage 36 hours after delivery. This is the fifth documented case in a neonate and the only one in whom survival had occurred beyond one hour. brain tissue emboli in the pulmonary circulation occur very rarely; it has been described in adults and children with head injuries. In newborn infants with severe congenital malformations of the central nervous system, brain tissue has been found growing in the lungs; the possibility of this being the result of prenatal brain trauma with embolization has been raised. In newborn infants, pulmonary brain tissue embolism as a result of birth trauma has been reported only very rarely; as far as the authors are aware, only four such cases have been documented. In view of the rarity of this condition, it was thought that the present case merited reporting.- - - - - - - - - - ranking = 1keywords = brain (Clic here for more details about this article) |
2/26. Unexpected birth trauma with near fatal consequences.Rupturing of the liver due to delivery is an uncommon but severe birth trauma. Although described in the preterm neonate with very low birthweight or after complicated delivery, we present a case of capsular liver haemorrhage in a term newborn with normal birthweight after a seemingly uncomplicated delivery. The infant presented with severe shock and petechiae as first symptoms and initial therapy was based on the hypothesis of sepsis. Clinical suspicion of liver haemorrhage a few hours later was confirmed with abdominal ultrasound. Since shock was not amenable to fluid replacement therapy, the haemorrhage had to be managed surgically. Even without evidence of birth trauma, intra-abdominal bleeding must always be suspected in a newborn with suddenly prevailing shock and unexpected anaemia.- - - - - - - - - - ranking = 117.95902119779keywords = haemorrhage (Clic here for more details about this article) |
3/26. Reorganisation of the sensorimotor cortex after early focal brain lesion: a functional MRI study in monozygotic twins.Sensorimotor cortical reorganization after early brain lesions was studied by means of fMRI in two pairs of monozygotic twins, in each of which one member had a focal brain injury. This offered a unique opportunity to reduce the wide intersubject variability of the controls often found in similar studies. Activation images were acquired during a motor task (sequential opposition finger movements) and a sensory task (passive brushing of palm and fingers). During the tasks with the recovered hand, constant findings in the lesioned subjects were the activation of the undamaged areas adjacent to lesion site and the activation of the ipsilateral sensorimotor cortex. Bilateral activation of the primary sensorimotor cortex was never observed in the healthy co-twin controls.- - - - - - - - - - ranking = 0.75keywords = brain (Clic here for more details about this article) |
4/26. Case report: injury of the spinal cord at birth.spinal cord injury may occur as a severe complication to delivery. In the vast majority of such cases the injury results from a traumatic breech delivery, but cases of injuries after cephalic presentation and fetal malposition have also been described. Two cases were reported. One of the infants died at the age of 8 months and neuropathological examination of the brain and spinal cord was performed. The other child, now 6 years old, is still alive. incidence, mechanism of injury, clinical and morphological features, and treatment are briefly discussed.- - - - - - - - - - ranking = 0.125keywords = brain (Clic here for more details about this article) |
5/26. The hypothalamus.The hypothalamus is an integral part of the neuroendocrine system. The anatomy, embryologic development, and normal function of the hypothalamus are described here. Pathophysiology of congenital abnormalities and brain injury is discussed and a case study examined. In addition, nursing implications of caring for such an infant are addressed.- - - - - - - - - - ranking = 0.125keywords = brain (Clic here for more details about this article) |
6/26. Delayed onset of status epilepticus after transient asphyxia in an asymptomatic full-term neonate.A full-term neonate presented with status epilepticus at 12 hours of age after a symptom-free interval following transient asphyxia at birth. Conventional neuroimaging failed to detect structural correlates to support recent injury. However, diffusion-weighted magnetic resonance imaging studies revealed recent ischemic brain injury. Placental examination documented multiple subacute and chronic findings indicative of decreased maternal/fetal perfusion. These antepartum placental abnormalities may have been associated with this child's inability to withstand the stress of a prolonged second stage of labor, resulting in intrapartum asphyxia leading to brain injury. This child's clinical presentation highlights the delayed reperfusion phase after ischemia-induced brain injury.- - - - - - - - - - ranking = 0.375keywords = brain (Clic here for more details about this article) |
7/26. Neonatal subgaleal hematoma causing brain compression: report of two cases and review of the literature.OBJECTIVE AND IMPORTANCE: Neonatal subgaleal hematomas (SGHs) are infrequent but underdiagnosed collections of blood beneath the galea, often caused by vacuum delivery. With massive bleeding into the subgaleal space, exsanguination and hypovolemic shock can cause death in 20 to 60% of newborn infants. We report the first two known patients with extracranial cerebral compression caused by SGH. Also, the surgical evacuation of neonatal SGH has not been described previously. CLINICAL PRESENTATION: One patient was a full-term boy who was delivered via vacuum extraction after an uncomplicated pregnancy. Within a few hours, he developed an expanding fluid collection of the scalp and disseminated intravascular coagulation and shock requiring intubation, inotropic support, and blood transfusions. His head circumference grew from 33 cm at birth to 42 cm. He became progressively lethargic and developed posturing movements. Computed tomography of the head revealed a massive SGH causing gross overlapping of the cranial sutures and diffuse cerebral edema. The other patient was a full-term boy delivered via cesarean section after an unsuccessful attempt at vacuum extraction and forceps delivery. The initial head circumference was 34 cm. Within a few hours, he developed an expanding fluid collection of the scalp and became progressively lethargic with posturing. magnetic resonance imaging of the head revealed a massive SGH with cranial compromise and diffuse cerebral edema. INTERVENTION: Both children had radiographic features indicative of elevated intracranial pressure as well as neurological decompensation. The first patient was taken to the operating room, and the hematoma was evacuated through a small scalp incision. Initially, approximately 150 ml of blood was removed, and a Jackson-Pratt drain diverted another 200 ml of blood during the next 2 days. The infant made a good recovery. In the second case, the patient remained too unstable for operative intervention and died. CONCLUSION: Extracranial cerebral compression represents another way by which neonatal SGH may jeopardize the infant's life. Management consists of measures to correct hypovolemic shock and disseminated intravascular coagulation, as well as surgical intervention to control elevated intracranial pressure.- - - - - - - - - - ranking = 0.5keywords = brain (Clic here for more details about this article) |
8/26. vacuum assisted delivery--the need for caution.In the United Kingdom and Republic of ireland 10% of all deliveries are vacuum assisted. The vacuum is preferred over forceps because it is easier to perform and associated with less maternal morbidity. It is, however, also associated with subaponeurotic haemorrhage that has an incidence of 6.4 per 1000 vacuum assisted deliveries and a mortality of 23%. Based on a figure of 77,500 births annually in ireland, North and South, it is possible that as many as 11 neonatal deaths each year may attributable to what is generally considered a safe obstetric intervention. In north america concerns about the safety of vacuum assisted delivery resulted in the issuing of public health advisories in both canada and the united states. To date such concerns have not been raised in either the United Kingdom or Republic of ireland. We report a case of fatal subaponeurotic haemorrhage to highlight and bring these concerns to the attention of obstetricians, paediatricians and midwives. We also call for the introduction of a national surveillance in order to assess the true extent of this potentially fatal complication.- - - - - - - - - - ranking = 78.639347465192keywords = haemorrhage (Clic here for more details about this article) |
9/26. Leptomeningeal cyst: early diagnosis by color Doppler imaging.A newborn with a leptomeningeal cyst over the anterior fontanelle due to birth trauma is described. color Doppler flow sonograms were helpful to diagnose the leptomeningocele in its early stages and to differentiate it from a cephalhematoma or subgaleal haemorrhage by demonstrating cerebro-fugal flow in an arterial connection between the extracranial fluid collection and the dural space.- - - - - - - - - - ranking = 39.319673732596keywords = haemorrhage (Clic here for more details about this article) |
10/26. The association of hypopituitarism with small pituitary, invisible pituitary stalk, type 1 arnold-chiari malformation, and syringomyelia in seven patients born in breech position: a further proof of birth injury theory on the pathogenesis of "idiopathic hypopituitarism".We report seven cases of hypopituitarism all having a history of breech delivery, asphyxia at birth, and syringomyelia. A small pituitary gland was found on MRI or CT in six cases, invisible pituitary stalk on MRI in five cases, and type 1 arnold-chiari malformation in six cases. A constellation of these abnormalities are best explained by traction of brain and spinal cord of the subjects exerted during breech delivery and further support the primary role of birth trauma in the genesis of "idiopathic hypopituitarism".- - - - - - - - - - ranking = 0.125keywords = brain (Clic here for more details about this article) |
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