Yasser Soliman1, Kamran Yusuf2, Marc Blayney3, Amr I El Shahed1, Jaques Belik1. 1. Division of Neonatology, Department of Pediatrics, Hospital for Sick Children, School of Medicine, University of Toronto, Toronto, Ontario. 2. Section of Neonatology, Department of Pediatrics, University of Calgary, Calgary, Alberta. 3. Division of Neonatology, Department of Pediatrics, Moncton Hospital, University of Dalhousie, Moncton, New Brunswick.
Abstract
INTRODUCTION: Brain herniation is an extremely rare complication of hypoxic ischaemic encephalopathy (HIE) in the neonatal period with only a single report described. We report a 2-day-old term infant with severe HIE, who developed diffuse brain oedema and herniation. CASE PRESENTATION AND DESCRIPTION: A term female infant delivered by vacuum, required therapeutic hypothermia for severe encephalopathy. At 36 hours of age, a marked change in neurological status was noted with signs of brainstem involvement. A head Computed Tomography Scan showed uncal and tonsillar herniation. CONCLUSION: Vigilance in monitoring neonatal neurological status during therapeutic hypothermia is imperative for early brain herniation detection.
INTRODUCTION: Brain herniation is an extremely rare complication of hypoxic ischaemic encephalopathy (HIE) in the neonatal period with only a single report described. We report a 2-day-old term infant with severe HIE, who developed diffuse brain oedema and herniation. CASE PRESENTATION AND DESCRIPTION: A term female infant delivered by vacuum, required therapeutic hypothermia for severe encephalopathy. At 36 hours of age, a marked change in neurological status was noted with signs of brainstem involvement. A head Computed Tomography Scan showed uncal and tonsillar herniation. CONCLUSION: Vigilance in monitoring neonatal neurological status during therapeutic hypothermia is imperative for early brain herniation detection.