Table of Contents
Washington University Experience | VASCULAR | Hemorrhage - Neonatal | 8A0 Case 8 History
Case 8 History ---- The patient was a three day old male infant, born at 37 weeks EGA to a 23 year old G2P2 mother after an uncomplicated pregnancy. Shortly after delivery, he was markedly hypoxic with severe respiratory acidosis. A large right diaphragmatic hernia with bowel in the right chest and leftward mediastinal shift was identified. On 2/1 he failed conventional ventilatory support and was placed on extracorporeal membrane oxygenation. On day of life #4, he developed a 2-3 cm left intracerebral hemorrhage and died. ---- At autopsy there was a large left frontal hemorrhage with extension into the subarachnoid space. The ventricles are symmetric and of normal size and shape and are lined by smooth, glistening ependyma. The choroid plexus has a hemorrhagic appearance. The cerebral aqueduct and fourth ventricle are patent, of normal size, and lined by smooth, glistening ependyma. No areas of hemorrhage, necrosis, calcification, malformation or neoplasm are present in the brainstem. ---- There was diffuse pallor of the white matter with astrocytosis, scattered apoptotic cells, rare calcifications and vascular prominence of likely hypoxic/ischemic origin. There is hemorrhage within the choroid plexus. Two infarcts are seen within the adjacent periventricular white matter. There was extensive subarachnoid hemorrhage involving the left cerebral hemisphere.
