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Washington University Experience | VASCULAR | Hydrocephalus, Post-Hemorrhagic | 1A0 Case 1 History
Case 1 History ---- This baby was the male twin A of a 28 week gestation who weighed 1290 grams at birth following an uneventful pregnancy. APGARS were 4 at one minute and 7 at 5 minutes. The baby suffered from respiratory distress syndrome, was intubated and was placed on a respirator. On the fourth day of life an LP showed grossly bloody fluid and he developed occasional seizures, treated with phenobarbital IV. A CT scan on the 7th day of life revealed a grade III IVH. By 10 days of life no neurological functioning had been evident for about 5 days and the patient was bradycardic. A repeat CT scan showed persistence of blood in the lateral ventricles whose size had increased and a ventriculostomy was placed. He developed a partial bowel obstruction, confirmed with barium enema. He started passing blood in his stools and his bilirubin increased to 32 total and 16.8 direct, thought to be due to early gut hypoperfusion with ischemia, hypoxia and focal infarction of the bowel wall. A repeat CT scan on about the 25th day of life revealed extreme ventricular dilatation. The baby was extubated on the 26th day of life and on the 30th day he became apneic and died.
