Cases reported "Birth Injuries"

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1/13. "Growing fontanelle": a serious complication of difficult vacuum extraction.

    Growing skull fractures in combination with leptomeningeal cysts are well known in childhood. A rare case of a growing fontanelle due to a leptomeningeal cyst is presented. The cyst occurred due to a traumatic delivery with vacuum extraction. Operative repair of the cyst revealed a dural tear at the border of the fontanelle. The imaging findings are discussed.
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ranking = 1
keywords = skull fracture, skull
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2/13. Congenital skull fracture as a presentation of Menkes disease.

    We report the rare presentation of Menkes disease with a congenital skull fracture, intracerebral bleeding, and seizures. The diagnosis was made at 3 months of age based on the characteristic features of the syndrome, by which time the child experienced uncontrollable seizures. Following progressive neurodegeneration, death occurred at 3 years of age. The prognosis in Menkes disease is dependent on early copper-histidine therapy. Effective treatment has led to children surviving into adulthood. Diagnosing the syndrome during the neonatal period is difficult. There are no published reports of congenital skull fracture as a presenting sign of Menkes disease. It is concluded that Menkes disease should be considered in any child who presents with congenital skull fracture as early diagnosis and treatment significantly improve the outcome.
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ranking = 6.0034043008551
keywords = skull fracture, skull
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3/13. Occipital osteodiastasis: presentation of four cases and review of the literature.

    BACKGROUND: Occipital osteodiastasis (OOD) is a form of birth injury characterized by a tear along the innominate (posterior occipital or supraoccipital-exoccipital) synchondrosis with separation of the occipital squama from the lateral or condylar parts of the occipital bone. The condition, frequently mentioned in the older literature as relatively common and invariably fatal, has been attributed to excessive pressure exerted over the subocciput during delivery, resulting in a forward and upward displacement of the anterior margin of the occipital squama into the posterior cranial fossa, with posterior fossa hemorrhage and other intracranial complications. Most likely as the result of improved obstetric techniques, this severe form of OOD has become quite rare or non-existent. A less severe form compatible with survival has been suggested, but so far only one case has been reported in some detail. MATERIALS AND methods: This paper reports the occurrence of this less severe form of OOD diagnosed roentgenographically in two infants who survived: a newborn and a 3-month-old child. Two additional cases of a similar lesion but of postnatal onset are also described: a 3-month-old infant with the diagnosis of child abuse who also survived and a 2-year-old girl who was involved in a fatal motor-pedestrian collision. RESULTS: Based on cases in the literature and the present material, three forms of OOD can be considered: a classic, fatal form; a less severe variant compatible with survival; and OOD of postnatal onset. The diagnosis can be made on lateral skull or cervical spine roentgenograms showing specific changes in the area of the innominate synchondrosis.
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ranking = 0.0034043008550763
keywords = skull
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4/13. Management of depressed skull fracture in the newborn.

    The authors describe 3 cases of neonatal depressed skull fracture subsequent to difficult delivery, treated without surgical elevation. None of the patients developed neurological deficits, cosmetic deformity or electroencephalographic signs of epileptiform activity. Neonatal depressed skull fractures not associated with focal neurological signs may not require surgical therapy; we are not certain what the absolute criteria for operation should be.
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ranking = 6
keywords = skull fracture, skull
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5/13. Contralateral occipital depression related to obstetric forceps injury to the eye.

    Obstetric forceps pressure strong enough to leave a periorbital depression and corneal injury would probably be severe enough to leave an occipital depression from the opposite forceps blade. The presence of a depression at the correct occipital position would support the diagnosis of forceps injury when the birth history is unknown and the cornea has decompensated enough to make observation of the Descemet's membrane scrolls difficult. We studied six patients with known or suspected obstetric forceps injury to the cornea. Complete ocular examinations included examination for periorbital forceps depressions and posterior skull depressions 180 degrees from the affected cornea (which correlates with the opposite blade of the forceps). All of the patients with Descemet's scrolls had posterior skull depressions. This method of palpation for a contralateral skull depression may assist in the diagnosis of forceps-induced corneal decompensation.
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ranking = 0.010212902565229
keywords = skull
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6/13. Neonatal skull depression: review of four cases.

    Neonatal skull depressions may occur from traumatic delivery or abnormal intrauterine position. Surgery has been recommended when the condition is thought to threaten neurologic development; however, normal neurologic outcomes have been observed in conservatively managed infants. A review of four patients with neonatal skull depression is presented together with the obstetric history and findings from nursery examinations, skull roentgenograms, electroencephalograms, and follow-up pediatric visits. Two patients underwent surgical elevation of the depression, while two children with depressions of similar severity were managed without intervention. Neurologic and cosmetic outcomes have been normal in all four patients. It is suggested that uncomplicated depressions should be treated conservatively, with surgical elevation reserved for neonates with intracranial complications.
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ranking = 0.023830105985534
keywords = skull
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7/13. communication between epidural hematoma and cephalhematoma in a neonate.

    A case of neonatal epidural hematoma caused by falling at a premature delivery is presented. It accompanied a cephalhematoma communicating to the epidural hematoma through a fracture of the skull. The mechanism of this peculiar form of neonatal epidural hematoma is discussed.
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ranking = 0.0034043008550763
keywords = skull
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8/13. Congenital depression of the neonatal skull.

    Congenital depression of the neonatal skull has had an incidence of 0.1% (1/10 000) in our newborn population during the past 8 years. These skull depressions have two pathogenetic types: deformation without fracture and fracture accompanied by depression. The cause of skull depression being the pressure exerted by the digits and fist of the newborn on his skull has not been previously reported. The treatment of choice for selected cases is nonsurgical elevation with an obstetric vacuum extractor. A CT scan should be performed prior to this treatment to rule out intracranial complications such as hemorrhage.
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ranking = 0.027234406840611
keywords = skull
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9/13. Depressed skull fracture in the neonate. Report of three cases.

    The authors describe three cases of neonatal depressed skull fracture that were elevated by means of an obstetrical vacuum extractor. In one case, a transparent breast pump shield replaced the metal vacuum extractor cup, permitting direct observation as the depression was elevated. Neonatal depressed skull fractures not associated with neurological signs may be safely elevated without surgery using the obstetrical vacuum extractor.
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ranking = 6
keywords = skull fracture, skull
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10/13. Intrauterine depressed skull fractures of the newborn.

    Intrauterine depressed skull fractures are reported only occasionally. In reviewing the literature it seems clear that pressure of the fetal head against the maternal bony structures, mainly the sacral promontory, accounts for most of the so-called "spontaneous" congenital depressed skull fractures. Rather than true fractures, they are focal congenital moulding depressions. On the other hand, trauma to the mother's abdomen and traumatic delivery are accepted pathological mechanisms for such lesions; most commonly they are ascribed to inexpert application of the forceps blades or undue force by the obstetrician at the time of birth. In some cases, however, uncomplicated spontaneous vaginal or cesarean section deliveries have surprisingly and unexpectedly yielded infants with depressed skull fractures. Three such cases are reported, and the literature is reviewed.
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ranking = 7
keywords = skull fracture, skull
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