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Watershed infarcts in the full term neonatal brain

Wilhelmina Children’s Hospital/University Medical Center Utrecht, Netherlands

Correspondence to:
Correspondence to:
Dr Groenendaal
Department of Neonatology, Wilhelmina Children’s Hospital, UMC Utrecht, Room KE 04.123.1, Lundlaan 6, Utrecht 3584 EA, Netherlands; f.groenendaal@wkz.azu.nl

The first 150 words of the full text of this article appear below.

Watershed infarcts, or parasagittal cerebral injury, were demonstrated in the asphyxiated neonatal brain the late 1970s with the use of technetium scans,^1–3 but were extremely difficult to visualise in the acute phase in vivo.^2,4,5

Recently, a full term boy was born after a caesarean section because of mild fetal distress. A cephalic version was performed at 38 weeks, but the pregnancy was otherwise uneventful. Umbilical arterial pH was 7.31, and Apgar scores were 8 and 9 at one and five minutes respectively. Birth weight was 3160 g. Twenty three hours after birth the baby developed left sided seizures with secondary generalisation. Seizures were treated effectively with phenobarbital, lidocaine, and midazolam. No infection, anaemia, or hypotension were demonstrated. Fifty six hours after birth, magnetic resonance imaging (MRI) was performed, which showed parasagittal changes (watershed infarcts) with diffusion weighted MRI. The apparent diffusion coefficient of water of these areas was 0.70 x . . . [Full text of this article]