Gaby je izbrskala en članek, o novorojenčku s podobno poškodbo, kot jo je imela Ema.

Povzetek:

A three-day-old male child was referred from a maternity home for convulsions and drowsiness. He was a full term baby with vertex presentation, delivered vaginally without episiotomy or any other instrumentation. The process of labor was uneventful without any undue prolongation of any stage of labor. There was no maternal history of cephalopelvic disproportion, bleeding diathesis or epilepsy during pregnancy. There was no history of trauma or fall during antenatal period. Baby cried immediately after birth. The weight of the baby was 2.1 kg at birth. The APGAR score was 8/10 at birth, 1 minute and 5 minutes. The baby was not having any congenital anomalies. No gross scalp swelling was found. The baby was not taking breast-feeds adequately & had 2 episodes of vomiting on 2nd day. On the 3rd day after delivery, the baby had repeated attacks of generalized tonic & clonic seizures followed by drowsiness. On examination, the baby was icteric and drowsy; pupils were 4 mm bilaterally and sluggishly reacting to light. Baby was showing abnormal flexion to painful stimuli on both sides with extensor plantar reflexes and both fontanale were bulging. Complete blood count and ESR were normal. Coagulation profile along with serum biochemistry was within normal limits except serum Bilirubin, which was 12.6 mg%. Ultrasound of the head was performed which has revealed large surface extending intracerebral hyperechoic lesion mainly in the right frontoparietal region. A CT Scan (Brain) revealed 4.5 cm x 3.5 cm x 1.4 cm sized SDH with Intracerebral haematoma of 6 cm x 3.8 cm x 2.8 cm with parietal depressed fracture with subarachnoid hemorrhage with EDH involving right frontoparietal region with mass effect on frontal horn of ipsilateral lateral ventricle. [Figure – 1] and [Figure – 2]. As baby was deteriorating neurologically, decision for evacuation of the intracranial hematoma was taken. Before surgery, the baby was showing extensor response to painful stimuli with dilated non-reacting pupils. The baby was taken up for an emergency craniotomy with elevation of depressed fracture with evacuation of EDH & SDH under general anesthesia. An intraparenchymal hematoma was also evacuated and after that brain became lax & pulsatile. The baby has showed signs of improvement within 24 hours. His pupils had started reacting to light and was showing flexion response to painful stimuli. Over a period of four days baby had started opening eyes with spontaneous limb movements with weak cry. On the 8th day after surgery, baby developed cerebrospinal fluid leak, which stopped within 72 hours after starting Tab. Acetazolamide. Breast-feeding was started on 10th day. Baby was discharged on 12th day with spontaneous eye opening, moving all four limbs and crying normally. Follow-up visit at 1 year, baby is doing well with no neurological deficit. Baby was able to sit without support and was walking with support.

Poudarki v besedilu so moji. V bistvu na nek način razveseljivo branje. 🙂 Psica teži, grem.