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Related Experiment Videos

Traumatic neonatal intracranial bleeding and stroke.

P Govaert1, P Vanhaesebrouck, C de Praeter

  • 1Department of Paediatrics, Gent University Hospital, Belgium.

Archives of Disease in Childhood
|July 1, 1992
PubMed
Summary

Birth trauma can cause cerebral ischemia in infants, affecting arteries like the posterior cerebral artery and middle cerebral artery. This can lead to permanent neurological damage, particularly after forceps or vacuum-assisted delivery.

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Area of Science:

  • Neurology
  • Pediatrics
  • Neonatal Care

Background:

  • Cerebral ischemia following birth injury is a known complication.
  • Ischemia can affect territories supplied by vertebral, posterior cerebral, and middle cerebral arteries.
  • Mechanisms include direct trauma, uncal herniation, and vessel stretch injury.

Observation:

  • This study details seven cases of birth trauma and related cerebral stroke.
  • Three neonates presented with occipital stroke due to uncal herniation.
  • Four infants experienced middle cerebral artery hypoperfusion, linked to subdural hemorrhage or contusion.

Findings:

  • Occipital stroke in neonates is associated with uncal herniation.
  • Middle cerebral artery hypoperfusion can result from basal subdural hemorrhage or parietal lobe contusion.
  • Vasospasm from extravasated blood is a potential contributing factor, supported by experimental data.

Implications:

  • Forceps delivery and difficult vacuum extraction are implicated in supratentorial injuries.
  • Cerebral ischemia from birth trauma can cause permanent neurological deficits in survivors.
  • Understanding these mechanisms is crucial for preventing neonatal brain injury.

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