Management of Intracranial Hemorrhage and Skull Fracture After Blunt Intrauterine Trauma

Autor: Justin M Cappuzzo, Matthew J. Recker, Veetai Li
Rok vydání: 2020
Předmět:
Zdroj: World Neurosurgery. 138:352-354
ISSN: 1878-8750
DOI: 10.1016/j.wneu.2020.03.089
Popis: Background Fetal trauma during pregnancy can have a significant impact on the developing brain. Fetal trauma can lead to several intracranial pathologies including hypoxic-ischemic injury, skull fractures, and intracranial hemorrhages. Blunt trauma to a fetus resulting in the need for neurosurgical intervention is a rare occurrence and seldom described in the literature. Case Description Here we present the case of a 28-year-old, 36-week pregnant woman who was brought to the hospital by ambulance following a high-speed motor vehicle collision as the restrained driver. On computed tomography of the abdomen, the fetus was found to have a left-sided skull fracture with intracranial hemorrhage. The fetus was emergently delivered by way of caesarean section for lack of fetal movement and indeterminate heart tracings. Postnatally, the neonate had a Glasgow Coma Scale of 7. A postnatal head computed tomography better defined the skull fractures and multiple areas of intracranial hemorrhage. The baby was taken to the operating room for evacuation of the hematomas. At 16 months of age, the baby was well with only mild developmental delay, although a ventriculoperitoneal shunt was needed in a delayed fashion at 3 months of age. Conclusions We present a rare situation where emergent caesarean section delivery followed by neonatal craniotomy was necessary. Our case illustrates that good outcomes can be achieved with rapid identification of fetal intracranial injury and intervention.
Databáze: OpenAIRE
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