A Case of In Utero Fetal Brain Trauma after Motor Vehicle Collision

Alley, John R.; Yahagi, Yusuke; Moncure, Michael; Strickler, Jeffery

doi:10.1097/01.ta.0000047900.29397.17

Cited by 5 publications

(9 citation statements)

References 4 publications

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“…This justifies careful monitoring of the fetus, even in a minor trauma, as quickly as possible after the traumatic insult. Focusing on fetal injuries, most case reports and studies after blunt abdominal trauma report brain injury with an associated high mortality rate [8,10,13].…”

Section: Discussionmentioning

confidence: 99%

“…An enlarged and echogenic pericerebral space (pc) was clearly seen on US a; widening and increased echogenicity of the interhemispheric fissure (if) and sulci (s) at the cerebral convexity, pathognomonic for subarachnoidal hemorrhage b vascular compromise of the brain. Several studies have shown that maternal death, high injury severity score (ISS), maternal shock, partial or complete abruptio placentae, eventually with associated disseminated intravascular coagulopathy (DIC), or, although infrequent, an acute uterine rupture in case of severe abdominal trauma are the most dangerous risk factors for hemodynamic compromise of the fetus, ultimately leading to fetal death in the worst cases [10,13].…”

Section: Discussionmentioning

confidence: 99%

“…Fetal head trauma is probably due to acute acceleration-deceleration forces in utero and can result in parenchymal or intraventricular contusions or hemorrhage in the subarachnoidal or subdural space [2,10].…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, all four babies died because of severe brain injury related to the traumatic insult. Injury of the fetus in blunt trauma is most frequent in the last trimester of pregnancy and often involves the fetal head [2,10].…”

Section: Introductionmentioning

confidence: 99%

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Fetal trauma: brain imaging in four neonates

et al. 2004

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The purpose of this paper is to describe brain pathology in neonates after major traffic trauma in utero during the third trimester. Our patient cohort consisted of four neonates born by emergency cesarean section after car accident in the third trimester of pregnancy. The median gestational age ( n=4) was 36 weeks (range: 30-38). Immediate post-natal and follow-up brain imaging consisted of cranial ultrasound ( n=4), computed tomography (CT) ( n=1) and post-mortem magnetic resonance imaging (MRI) ( n=1). Pathology findings were correlated with the imaging findings ( n=3). Cranial ultrasound demonstrated a huge subarachnoidal hemorrhage ( n=1), subdural hematoma ( n=1), brain edema with inversion of the diastolic flow ( n=1) and severe ischemic changes ( n=1). In one case, CT demonstrated the presence and extension of the subarachnoidal hemorrhage, a parietal fracture and a limited intraventricular hemorrhage. Cerebellar hemorrhage and a small cerebral frontal contusion were seen on post-mortem MRI in a child with a major subarachnoidal hemorrhage on ultrasound. None of these four children survived (three children died within 2 days and one child died after 1 month). Blunt abdominal trauma during pregnancy can cause fetal cranial injury. In our cases, skull fracture, intracranial hemorrhage and hypoxic-ischemic encephalopathy were encountered.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Fetal trauma: brain imaging in four neonates

et al. 2004

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“… 1 , 2 , 3 Fetal intracranial hemorrhage in the circumstance of maternal trauma tends to be even rarer due to the fact that the cushion of the uterus and amniotic fluid are protective. 4 When such fetal injuries exist, it is evidence of the magnitude of blunt force to the maternal abdomen. 4 …”

Section: Discussionmentioning

confidence: 99%

Traumatic Fetal Intracranial Hemorrhage Suggested by Point-of-Care Ultrasound

Mooney

Vrablík

2018

CPCEM

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While the use of ultrasound to diagnose a fetal intracranial hemorrhage in utero is not a new concept, the emphasis of point-of-care ultrasound (POCUS) at the initial trauma presentation of the mother to evaluate for fetal injury is novel. A review of the literature failed to reveal a single case report wherein POCUS in the workup of a pregnant trauma patient led to the diagnosis of fetal intracranial hemorrhage. This is such a case.

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