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      Delayed Appearance of a Traumatic Fetal Intracranial Hemorrhage

      case-report
      , ,
      Case Reports in Obstetrics and Gynecology
      Hindawi

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          Abstract

          Background

          Fetal intracranial injury is a potentially devastating sequelae of maternal trauma, but there is little guidance regarding fetal evaluation in this setting.

          Case

          A 23-year-old woman at 27-week gestation was admitted after a high-speed motor vehicle accident. The initial obstetrical ultrasound was unremarkable, but persistently minimal fetal heart rate variability was observed. Ultrasound on day 3 after the accident showed an intracranial hyperechogenic lesion and subdural fluid collection. The neonate, following an uneventful birth at 39 weeks, had seizures and abnormal muscle tone. MRI was consistent with in utero intracranial hemorrhage.

          Conclusion

          Serial fetal imaging following maternal trauma, particularly when accompanied by abnormal fetal heart rate tracings, should be considered when fetal injury is a concern, even in the setting of a normal initial ultrasound.

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          Most cited references14

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          Guidelines for the Management of a Pregnant Trauma Patient

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            Outcome of antenatally diagnosed intracranial hemorrhage: case series and review of the literature.

            Prenatal diagnosis of intracranial hemorrhage (ICH) has been widely reported. Hemorrhages may occur either within the cerebral ventricles, subdural space or infratentorial fossa. The aim of this study was to determine the sonographic criteria for the diagnosis of fetal ICH, the role of in utero magnetic resonance imaging (MRI) and the outcome of this condition.
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              Intracranial hemorrhage: ultrasound, CT and MRI findings.

              Intracranial hemorrhage is one of the most common causes of acute focal neurologic deficit in children and adults. Neuroimaging including ultrasonography (US), computer tomography (CT) and magnetic resonance imaging (MRI) is essential in the diagnosis of intracranial hemorrhage. Imaging findings should guide treatment. The highly variable appearance of an intracranial hemorrhage can be challenging. A thorough knowledge of hematoma evolution and US, CT and MR hematoma characteristics is mandatory for adequate interpretation of findings. The purpose of this review is (1) to summarize the imaging characteristics of intracranial hemorrhage on various imaging techniques and (2) to review the various types of intracranial hemorrhage, and their causes.
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                Author and article information

                Contributors
                Journal
                Case Rep Obstet Gynecol
                Case Rep Obstet Gynecol
                CRIOG
                Case Reports in Obstetrics and Gynecology
                Hindawi
                2090-6684
                2090-6692
                2018
                27 February 2018
                : 2018
                : 1465034
                Affiliations
                Department of Obstetrics, Gynecology, and Women's Health, University of Hawaii John A Burns School of Medicine, Honolulu, HI, USA
                Author notes

                Academic Editor: Erich Cosmi

                Author information
                http://orcid.org/0000-0003-1730-6324
                Article
                10.1155/2018/1465034
                5848104
                3b340ec0-fc56-4a8f-a68e-b20a9471b38e
                Copyright © 2018 Kelly Yamasato et al.

                This is an open access article distributed under the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

                History
                : 15 September 2017
                : 1 February 2018
                Categories
                Case Report

                Obstetrics & Gynecology
                Obstetrics & Gynecology

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