Download PDF
CC BY-NC-ND 4.0 · AJP Rep 2017; 07(03): e171-e173
DOI: 10.1055/s-0037-1605372
Case Report
Thieme Medical Publishers 333 Seventh Avenue, New York, NY 10001, USA.

Term Neonate with Atypical Hypoxic-Ischemic Encephalopathy Presentation: A Case Report

Nick Townley
1   Division of Neonatology, Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri
,
Emily McNellis
1   Division of Neonatology, Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri
,
Venkatesh Sampath
1   Division of Neonatology, Department of Pediatrics, Children's Mercy Hospital, Kansas City, Missouri
› Author Affiliations
Further Information

Publication History

29 November 2016

30 June 2017

Publication Date:
28 August 2017 (online)

   Permissions and Reprints

Abstract

We describe a case of atypical hypoxic-ischemic encephalopathy (HIE) in a neonate following a normal pregnancy and delivery who was found to have an umbilical vein thrombosis. The infant arrived to our center with continuous bicycling movement of her lower extremities. She had a continuous electroencephalogram that showed burst suppression and magnetic resonance imaging of the brain showed diffusely abnormal cerebral cortical/subcortical diffusion restriction which may be secondary hypoxic-ischemic injury. Interestingly, a pathology report noted a focal umbilical vein thrombosis appearing to have compressed an umbilical artery with associated arterial dissection and hematoma. Our case illustrates how umbilical venous or arterial thrombosis may be associated with HIE and refractory seizures.

Keywords

Hypoxic-ischemic encephalopathy - umbilical vein thrombosis - status epilepticus
 

  • References

  • 1 Gillam-Krakauer M, Carter BS. Neonatal hypoxia and seizures. Pediatr Rev 2012; 33 (09) 387-396 , quiz 397
    CrossrefPubMedGoogle Scholar
  • 2 Martinez-Biarge M, Diez-Sebastian J, Wusthoff CJ, Mercuri E, Cowan FM. Antepartum and intrapartum factors preceding neonatal hypoxic-ischemic encephalopathy. Pediatrics 2013; 132 (04) e952-e959
    CrossrefPubMedGoogle Scholar
  • 3 Parast MM, Crum CP, Boyd TK. Placental histologic criteria for umbilical blood flow restriction in unexplained stillbirth. Hum Pathol 2008; 39 (06) 948-953
    CrossrefPubMedGoogle Scholar
  • 4 Redline RW. Clinical and pathological umbilical cord abnormalities in fetal thrombotic vasculopathy. Hum Pathol 2004; 35 (12) 1494-1498
    CrossrefPubMedGoogle Scholar
  • 5 Heifetz SA. Thrombosis of the umbilical cord: analysis of 52 cases and literature review. Pediatr Pathol 1988; 8 (01) 37-54
    CrossrefPubMedGoogle Scholar
  • 6 Chan JS, Baergen RN. Gross umbilical cord complications are associated with placental lesions of circulatory stasis and fetal hypoxia. Pediatr Dev Pathol 2012; 15 (06) 487-494
    CrossrefPubMedGoogle Scholar
  • 7 Baergen RN. Cord abnormalities, structural lesions, and cord “accidents”. Semin Diagn Pathol 2007; 24 (01) 23-32
    CrossrefPubMedGoogle Scholar
  • 8 Shilling C, Walsh C, Downey P, Mooney E. Umbilical artery thrombosis is a rare but clinically important finding: a series of 7 cases with clinical outcomes. Pediatr Dev Pathol 2014; 17 (02) 89-93
    CrossrefPubMedGoogle Scholar
  • 9 Drury PP, Davidson JO, van den Heuij LG. , et al. Status epilepticus after prolonged umbilical cord occlusion is associated with greater neural injury in [corrected] fetal sheep at term-equivalent. PLoS One 2014; 9 (05) e96530
    CrossrefPubMedGoogle Scholar