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Radiological Case of the Month

Radiological Case of the Month Abstract A 1220-g male neonate (estimated gestational age, 29 weeks) was born via low-forceps vaginal delivery to an 18-year-old woman (gravida 1) hospitalized for lower abdominal pain and vaginal bleeding. The neonate was limp and cyanotic at birth. His initial heart rate of 50 beats per minute increased to greater than 100 beats per minute after endotracheal intubation, mechanical ventilation, and intramuscular administration of 0.16 mg of atropine sulfate. Apgar scores were 1 and 7 at one and five minutes, respectively. Ultrasonograms of the head at 2 days of age were normal. The neonate's hospital course was marked by hyaline membrane disease and subsequent bronchopulmonary dysplasia. On day 20, he suffered a severe hypoxic episode requiring cardiopulmonary resuscitation. Subsequently, head ultrasonograms (Figs 1 and 2) and computed tomographic (CT) scans (Fig 3) were obtained. Perinatal asphyxia in the neonate is a well-recognized cause of brain dam Denouement and Discussion Postasphyxial Total References 1. Volpe JJ: Perinatal hypoxic-ischemic brain injury . Pediatr Clin North Am 1976;23:383-397. 2. Magilner AD, Wertheimer IS: Preliminary results of a computed tomography study of neonatal brain hypoxia-ischemia . J Comput Assist Tomogr 1980;4:457-463.Crossref 3. Hirabayashi S, Kitahara T, Hishida T: Computed tomography in perinatal hypoxic and hypoglycemic encephalopathy with emphasis on follow-up studies . J Comput Assist Tomogr 1980;4: 451-456.Crossref 4. Schrumpf JD, Sehring S, Killpack S, et al: Correlation of early neurologic outcome and CT findings in neonatal brain hypoxia and injury . J Comput Assist Tomogr 1980;4:445-450.Crossref 5. Flodmark O, Fitz CR, Harwood-Nash DC: CT diagnosis and short-term prognosis of intracranial hemorrhage and hypoxic/ischemic brain damage in neonates . J Comput Assist Tomogr 1980;4:775-787.Crossref 6. Fitzhardinge PM, Flodmark O, Fitz CR, et al: The prognostic value of computed tomography as an adjunct to assessment of the term infant with postasphyxial encephalopathy . J Pediatr 1981;99:777-781.Crossref 7. Babcock DS, Ball W Jr: Postasphyxial encephalopathy in full-term infants: Ultrasound diagnosis . Radiology 1983;148:417-423.Crossref http://www.deepdyve.com/assets/images/DeepDyve-Logo-lg.png American Journal of Diseases of Children American Medical Association

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Publisher
American Medical Association
Copyright
Copyright © 1987 American Medical Association. All Rights Reserved.
ISSN
0002-922X
DOI
10.1001/archpedi.1987.04460040103026
Publisher site
See Article on Publisher Site

Abstract

Abstract A 1220-g male neonate (estimated gestational age, 29 weeks) was born via low-forceps vaginal delivery to an 18-year-old woman (gravida 1) hospitalized for lower abdominal pain and vaginal bleeding. The neonate was limp and cyanotic at birth. His initial heart rate of 50 beats per minute increased to greater than 100 beats per minute after endotracheal intubation, mechanical ventilation, and intramuscular administration of 0.16 mg of atropine sulfate. Apgar scores were 1 and 7 at one and five minutes, respectively. Ultrasonograms of the head at 2 days of age were normal. The neonate's hospital course was marked by hyaline membrane disease and subsequent bronchopulmonary dysplasia. On day 20, he suffered a severe hypoxic episode requiring cardiopulmonary resuscitation. Subsequently, head ultrasonograms (Figs 1 and 2) and computed tomographic (CT) scans (Fig 3) were obtained. Perinatal asphyxia in the neonate is a well-recognized cause of brain dam Denouement and Discussion Postasphyxial Total References 1. Volpe JJ: Perinatal hypoxic-ischemic brain injury . Pediatr Clin North Am 1976;23:383-397. 2. Magilner AD, Wertheimer IS: Preliminary results of a computed tomography study of neonatal brain hypoxia-ischemia . J Comput Assist Tomogr 1980;4:457-463.Crossref 3. Hirabayashi S, Kitahara T, Hishida T: Computed tomography in perinatal hypoxic and hypoglycemic encephalopathy with emphasis on follow-up studies . J Comput Assist Tomogr 1980;4: 451-456.Crossref 4. Schrumpf JD, Sehring S, Killpack S, et al: Correlation of early neurologic outcome and CT findings in neonatal brain hypoxia and injury . J Comput Assist Tomogr 1980;4:445-450.Crossref 5. Flodmark O, Fitz CR, Harwood-Nash DC: CT diagnosis and short-term prognosis of intracranial hemorrhage and hypoxic/ischemic brain damage in neonates . J Comput Assist Tomogr 1980;4:775-787.Crossref 6. Fitzhardinge PM, Flodmark O, Fitz CR, et al: The prognostic value of computed tomography as an adjunct to assessment of the term infant with postasphyxial encephalopathy . J Pediatr 1981;99:777-781.Crossref 7. Babcock DS, Ball W Jr: Postasphyxial encephalopathy in full-term infants: Ultrasound diagnosis . Radiology 1983;148:417-423.Crossref

Journal

American Journal of Diseases of ChildrenAmerican Medical Association

Published: Apr 1, 1987

References

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