Acute flaccid neonatal paraplegia: a case report

Area of Science:

• Neonatal medicine
• Pediatric neurology
• Vascular surgery

Background:

• Umbilical artery catheterization is a common neonatal procedure.
• Complications, though rare, can be severe.
• Understanding vascular anatomy is crucial for procedural safety.

Observation:

• A 3-day-old neonate developed acute, irreversible paraplegia below the L1/L2 vertebral level.
• The neurological deficit occurred shortly after umbilical artery catheterization.

Findings:

• The paraplegia was attributed to spinal cord infarction.
• Potential causes include thrombosis of the artery of Adamkiewicz or direct injection into the spinal cord circulation.
• The umbilical catheter's position in the aorta is implicated.

Implications:

• Careful placement of the umbilical catheter tip is essential.
• Consideration of more peripheral arterial catheterization may be warranted.
• This case highlights the critical importance of anatomical awareness during neonatal procedures to prevent devastating neurological injury.