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Published on: November 3, 2016
Spinal cord injury at birth: a hidden causative factor
Jesper Fenger-Gron1, Kirsten Kock, Rasmus G Nielsen
1Department of Pediatrics, Odense University Hospital, Denmark. jfg@grejsdalen.dk
Acta Paediatrica (Oslo, Norway : 1992)
|April 10, 2008
Summary
A severe case of perinatally acquired spinal cord injury (SCI) in an infant was diagnosed postmortem. Autopsy revealed a congenital cervical vertebrae malalignment, not previously reported, crucial for understanding such injuries.
Area of Science:
- Neonatal neurology
- Pediatric pathology
- Congenital abnormalities
Background:
- Perinatally acquired spinal cord injury (SCI) can present diagnostic challenges, especially with co-morbidities.
- Timely diagnosis is critical for appropriate management and prognosis in neonates with suspected SCI.
Observation:
- A neonate presented with symptoms suggestive of severe SCI following a breech presentation and Cesarean delivery.
- Delayed diagnosis occurred due to significant co-existing medical conditions.
- Lack of respiratory effort and spontaneous movements led to withdrawal of ventilatory support.
Findings:
- Autopsy revealed a significant congenital malalignment of the upper cervical vertebrae.
- Histological examination showed extensive reactive changes in the affected cervical region.
- These specific congenital findings in the context of perinatal SCI appear to be previously unreported.
Implications:
- This case underscores the importance of thorough postmortem examinations in cases of suspected perinatal SCI.
- A hidden congenital malformation can mimic or contribute to SCI, complicating malpractice claims.
- Accurate diagnosis, even posthumously, is vital for understanding etiology and preventing future occurrences.
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