Vacuum Extraction Delivery Complicated with Acute Subdural Hematoma and Cerebral Infarction: Report of One Case

眞空吸引造成急性硬2腦膜下出血併發腦梗塞：一病例報告

劉慧燕(Hui-Yen Liu) ； 黃立同(Li-Tung Huang) ； 呂鎭中(Chun-Chung Lui)

《Acta Paediatrica Sinica》 39卷2期 (1998/04) Pp. 119-122

https://doi.org/10.7097/APS.199804.0119

摘要

新生兒硬腦膜下出血常併發於生産時的傷害。我們的病人是一個足月女嬰，生産時有用眞空吸引，出生時並無異狀，出生23小時之後發生抽筋，同時有前囟門突出及貧血等症狀，經電腦斷層攝影檢查發現左側顳葉及右側額頂葉有硬腦膜下出血，病人在四天大時接受手術除去約20毫升的血液，術後情況大致良好。術後五天的磁振攝影發現仍有殘餘血塊在左側額顳葉及後顱窩。病人於四十五天大時再接受電腦斷層攝影檢查發現疑有兩側枕葉腦梗塞；四個月大時追蹤磁振血管攝影的確可見兩側後大腦動脈有血流受阻的現象。病人臨床上已無抽筋的表現，亦無發育遲緩，但卻有頭圍過小的情況。將來尚須密切追蹤頭圍成長及神經學的成熟與發展。
硬腦膜下出血在新生兒由眞空吸引生産者並不常見，但於術後追蹤時發現併發腦梗塞者卻極罕見，故提出報告。

關鍵字

硬腦膜下出血 ； 腦梗塞 ； 新生兒 ； 眞空吸引

並列摘要

We present a term, 2950 gm female neonate who was delivered by vacuum extration and subsequently developed convulsions 23 hours after birth. Acute subduralhematoma was rapidly diagnosed by computed tomographic brain scan and successfully removed. The patient had a smooth postoperative recovery but cerbral infarction was found during follow up imaging studies. Magnetic resonance angiography revealed poor visualization of bilateral posterior cerebral arteries. After a follow-up period of 4 months, the infant had normal neurological development except for mild microcephalus. We report the occurence of cerebral infarction in an infant following evacuation of a subdural hematoma. Onset of the late complication suggests the importance of serial neuroradiological and clinical evaluations.

並列關鍵字

subdural hematoma ； cerebral infarction ； neonate ； vacuum