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Washington University Experience | VASCULAR | Hypoxia-Ischemia, fetal-neonatal | Pontosubicular necrosis | 4A0 Case 4 History
Case 4 History ---- The decedent was a 9-day-old female infant born at 25 weeks EGA to a G2P2 mother with a history of preterm labor, delivered on 07/17 in a vehicle en route to the ER. Upon ER arrival, the infant was cyanotic and apneic; she was resuscitated and intubated. In her short life, the decedent suffered from complications of prematurity: respiratory distress syndrome, intraventricular hemorrhage (grade IV on left, grade III on right), bilateral cerebellar hemorrhages, recurrent seizures status post treatment, concerns for culture-negative sepsis requiring pressors, severe hyperglycemia on insulin, apnea of prematurity on caffeine, pulmonary hypertension (resolved at time of death), hyperbilirubinemia status post phototherapy, hypernatremia/hyperkalemia (resolved at time of death) and patent ductus arteriosus status post acetaminophen treatment. She developed bradycardia with refractory hypotension and, due to her poor prognosis, she was compassionately extubated, expiring on her 9th day of life. ---- Autopsy results confirmed extensive subacute intraventricular hemorrhage (Grade III) on left side with extension of germinal matrix hemorrhage to involve the brain parenchyma (Grade IV) on the right side, subacute periventricular infarcts involving basal ganglia and thalamus, mineralized cerebellar dentate nuclei neurons, and hydrocephalus.
