Pathology and Radiology: Perinatal Brain Injuries Flashcards
What is caput succedaneum?
Does it cross sutures lines?
Cutaneous hemorrhage over the kin shortly after birth which resolves in 48 hours. It is caused by pressure during birth with vascular stasis
It does cross suture lines
What is subaponeurotic hemorrhage?
Blood accumulating under the galea
What is a cephalohematoma?
Subperiosteal blood which does NOT cross suture lines. Often is parietal and may calcify
What are risks for perinatal subdural hematoma?
Small birth canal, abnormal presentation, premature birth with increased skull compliance, large head, forceps delivery
What are causes of perinatal subarachnoid hemorrhage? What kind of prognosis does it bear?
Asphyxia and hypoxia
Overall good outcome
Periventricular hemorrhage/IVH occurs how frequently in premature births with what affects on morbidity and mortality?
What location will it develop in and over what time frame?
40% of premature births
20-60% mortality rate and 10-40% morbidity rate
Germinal matrix in subependymal region near foramen of monro or body of caudate (in premature); may occur at choroid plexus of lateral ventricle in full term babies
Periventricular leukomalacia is due to acute hypoxic injury and leads to what symptoms often?
What are risk factors for?
Lower extremity weakness and vision problems
Sepsis, shock, congenital heart disease, respiratory distress syndrome
What locations within the brain are damaged in gray matter necrosis?
What is the cause and in what pediatric patient population is this seen in?
Subthalamus, LGB, inferior colliculus, cranial nerves, dentate nuclei, Purkinje cells, cortical internal granular layer
Full term births with perinatal asphyxia
What is ulegyria and in what situation does it occur?
Parietooccipital mushroom like gyri with atrophy to sulci occurring in chronic hypoxic perinatal injury
What is status marmoratus and in what situation does it occur?
Occurs in chronic hypoxic perinatal brain injury
Thalamus, neostriatum, and cortex develope irregular intersecting bands of myelin and astrocytic fibers caused by cell loss followed by remyelination
What is kernicterus?
What brain regions does it affect?
What is treatment?
Build up of unconjugated bilirubins which stains cells
Globus pallidus, thalamus, subthalamus, CN 3 and 8 causing extrapyramidal motor symptoms
Treat with phototherapy (UV light) but if > 20 then treat with exchange transfusion
What are causes of cavitary encephalopathies?
Infections, genetic defects, or toxic gases
What is porencephaly?
Cavitary encephalopathy where a cavity extends from leptomeninges to ventricles or superficial white matter and is lined by white matter
What is hydranencephaly?
Most of cortex replaced by CSF (caused by cerebral ischemia such as carotid occlusion, or infection)
What is multicystic encephalopathy?
Multiple cavities seen in ACA and MCA distributions
