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newborn with extensive SDH, EDH and ICH

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Baby I was admitted 2 days back with h/o secondary apnoea after LSCS for oligohydramnios. Mother had UTI in the last week of pregnancy.Baby needed intubation and he was transferred here.On arrival he had frank seizure. His sugar calcium normal. He had normal PT and normal range aptt( 40 sec) and low platelets.

He was ventilated and investigated.

I am attaching the CT scan pictures.

He is on phenobarb, phenytoin , midazolam and levitracetam. He is seizure free for the last 24 hrs.

His repeat CT shows almost same lesions which are more prominent.

Please share your views on the longterm outcome of the baby?

dr.selvan rathinasamy

Erode. India

post-870-13828084202_thumb.jpg

post-870-138280842047_thumb.jpg

post-870-138280842066_thumb.jpg

Even though the photos have poor contrast, it seems that the brain tissue has really poor differentiation between white/grey matter.

In addition, the lateral ventricles are barely visible ("slit ventricles"?).

There seems to be blood in the subdural space.

With the reservation for photo quality, the examination findings seems quite abnormal. Which could be associated with a poor prognosis?

Do you have more data from the history and clinical examination?

Hypoix events before/after delivery? DIC? Coagulopathy?

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baby had severe birth asphyxia.

a PTT was upper limit of normal.FDP to be send tomorrow. Has persistent thrombocytopenia needing platelet transfusions. Probably DIC if the results are taken along with low platelets

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