A case of prenatal cerebellar haemorrhage in a late preterm infant
ChiaraProtano, Neonatologist,
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Other Contributors:
April 12, 2011
Dear Editor,
in the article by McCarthy it emerged that cerebellar haemorrhage (CBH) is a rare condition typical of extreme prematurity, with male preponderance, and which always results in a very severe prognosis. We would like to present a case of CBH with different characteristics, as it appeared prenatally in a late preterm infant who finally survived. The baby was born at 35 weeks of GA by caesarean section for a worsening ventriculomegaly first diagnosed using cUS at 27 weeks and then confirmed with a fetal MRI at 30 weeks of GA. TORCH, thrombophilic screening and all Doppler scans were normal. Soon after birth the baby developed a respiratory distress which required intubation for ventilatory support and surfactant administration. A cUS performed within the first hour of life confirmed the dilation of both lateral ventricles and showed an echo dense lesion in each cerebellar hemisphere suggesting there had been a haemorrhage. Doppler scans of anterior and middle cerebral artery were normal. A second MRI undertaken on the 20th day when the baby was more stable, confirmed the ventriculomegaly without showing any sign of CBH. In our case the CBH occurred as an antenatal event since it was already ultrasonically detectable soon after birth, however its aetiology remains unknown. As reported in the article, CBH may be associated with circulatory disturbance in the extreme preterm brain. Our baby was a late preterm usually less vulnerable to any perfusion-reperfusion injury, and trauma should not have played any role as it was a caesarean section. The infants of the CBH group in the article were extremely preterm, critically unwell and all of them died while our baby survived and is now self ventilated in air.
Conflict of Interest:
None declared