Hypoxic-ischemic encephalopathy anoxic zone

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anoxic zone

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Contributed by:

Patrick lantz, WFUBMC, north carolina, USA.

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Discussion: this neonate was the product of a 36 4/7 week gestation. He was delivered at an outside hospital by emergency cesarean section because of decreased fetal movement and nonreassuring status on fetal heart tracing.Anoxic zone apgar scores were 0, 0 and 0. Resuscitation included intubation, chest compressions, and epinephrine. He was transferred to our medical center with a diagnosis of hypoxic ischemic encephalopathy thought to be due to either a nuchal cord or a cord knot. Upon arrival here he was maintained on ventilator and pressor support. Additional problems included pulmonary hypertension, patent ductus arteriosus with bidirectional shunting, anemia, thrombocytopenia, coagulopathy, renal failure, and hepatic failure. A cranial ultrasound was interpreted as showing cerebral edema and a left subdural hematoma with midline shift to the right. Neurologically, he exhibited clonus and was unresponsive throughout his hospital stay.Anoxic zone he was maintained on antibiotics as a precaution. His condition steadily deteriorated and he died two days after admission.

Autopsy (NP):

Global hypoxic ischemic brain injury

Large left frontal SAH and thin left SDH bilateral rhs (no clinical fundal exam evident in

Medical record)