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- Title
HYDRANENCEPHALY, EXTREMELY RARE CASES WITHOUT SOLUTIONS IN NEONATOLOGY.
- Authors
Buta, Oana Maria; Buta, Tudor Ioan; Marta, Paul Claudiu; Miron, Miruna Ioana; Rusneac, Monika; Cucerea, Manuela
- Abstract
Background: Hydranencephaly is a rare congenital abnormality characterized by the absence and replacement of the cerebral hemispheres with cerebrospinal fluid. It is one of the most severe forms of bilateral cerebral cortical anomaly. The most common etiology described is the occlusion of the supra-clinoid segment of bilateral internal carotid arteries causing ischemic degeneration of structures supplied by them. Objective: The purpose of our presentation is to highlight the fact that hydranencephaly discovered or not at any gestational age has the same unfortunate prognosis with or without surgery. Material and methods: We report a case of two newborns with massive hydranencephaly, which come from different gestational age, both are born with caesarean section for the onset of fetal distress with unfortunate prognosis of severe hydranencephaly. They also come from dispensational pregnancies, affirmatively without infections during pregnancy. The first born mature child, discovered antenatal at 27-28 weeks with massive hydranencephaly, was delivered by caesarean section, AGA, gestational age 41 weeks, with Apgar score: 7/1', 8/5' and weight 4.5 kg. The clinical examination reveals important macrocephaly through massive congenital hydrocephalus, cranial perimeter 50 cm, with eyes in the sunset, epicranial circulation expressed, bilateral cheilo-gnato-palato-schizis, and the other newborn with premature pathology, diagnosed with severe congenital hydranencephaly, VLBW, gestational age 26-27 weeks, the third child, was delivered by caesarean section, with Apgar score: 8/1', 8/5' and weight 1 kg, reanimated in the delivery room by aspirating the secretions, tactile stimulation and free flow oxygen with postpartum adaptation with respiratory distress syndrome mild form, intercostal print, with Oxigen saturations 99-100% under oxygen on the mask with 4l/minute. Conclusions: The first case was overcome without indication of peritoneal ventricular shunt due to the 50 cm cranial perimeter, and the second one with 27 cm cranial perimeter benefited from the shunt mounting. Both have unpredictable status.
- Subjects
INTERNAL carotid artery; CESAREAN section; RESPIRATORY distress syndrome; NEONATOLOGY; CEREBRAL hemispheres; FETAL distress
- Publication
Acta Medica Marisiensis, 2019, Vol 65, p35
- ISSN
2068-3324
- Publication type
Article