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Washington University Experience | VASCULAR | Cardiac Arrest Encephalopathy | 3A0 Case 3 History
Case 3 History ---- The patient was a 3880 gm full term (EGA 40 1/2 weeks) male infant born to a 35 year old mother on 7/17. Amniocentesis at 15 1/2 weeks secondary to a borderline AFP was "normal" and the rest of the pregnancy was uncomplicated. Delivery was by C-section for cephalopelvic disproportion and failure to progress 12 hours after rupture of membranes. Apgars were 9 at 1 and 9 at 5 minutes. At 01:00 on 7/19 he was fed without problems but 2 hours later he was found prone, pale and pulseless. He was resuscitated and intubated. He had no evidence of neurologic function and was oliguric. Echocardiogram to rule out congenital heart defects was normal. A head ultrasound was normal. Group B strep latex was negative and a lumbar puncture was minimally cellular. Because of the absence of neurological function, life support was discontinued and the patient expired on 7/20. There were no fetal anomalies in the general autopsy. Serial cross sections of the brainstem and cerebellum at 3-4 mm intervals revealed hemorrhagic necrosis in the basal ganglia, the lateral geniculate nuclei, the subthalamic nuclei, the tegmentum of the midbrain and the pons, the pontine nuclei, the inferior olivary nuclei and the dentate nuclei.
