Jensen A, Hamelmann E
Campus Clinic Gynecology, Ruhr-University Bochum, Universitätsstrasse 140, 44799 Bochum, Germany.
Department of Pediatrics, Ruhr-University Bochum, St. Josef-Hospital, Alexandrinenstrasse 5, 44791 Bochum, Germany; Department of Pediatrics, Evangelisches Krankenhaus Bielefeld, Kinderzentrum Bethel, Grenzweg 10, 33617 Bielefeld, Germany.
Case Rep Transplant. 2016;2016:1717426. doi: 10.1155/2016/1717426. Epub 2016 Apr 30.
Intracranial laceration due to traumatic birth injury is an extremely rare event affecting approximately one newborn per a population of 4.5 million. However, depending on the mode of injury, the resulting brain damage may lead to lifelong sequelae, for example, cerebral palsy for which there is no cure at present. Here we report a rare case of neonatal arterial ischemic stroke and cerebral palsy caused by fetal traumatic molding and parietal depression of the head during delivery caused by functional cephalopelvic disproportion due to a "long pelvis." This patient was treated by autologous cord blood mononuclear cells (45.8 mL, cryopreserved, TNC 2.53 × 10e8) with a remarkable recovery. Active rehabilitation was provided weekly. Follow-up examinations were at 3, 18, 34, and 57 months. Generous use of neonatal head MRI in case of molding, craniofacial deformity, and a sentinel event during parturition is advocated to enhance diagnosis of neonatal brain damage as a basis for fast and potentially causative treatment modalities including autologous cord blood transplantation in a timely manner.
因分娩损伤导致的颅内撕裂伤极为罕见，每450万新生儿中约有1例受影响。然而，根据损伤方式的不同，由此导致的脑损伤可能会引发终身后遗症，例如目前无法治愈的脑瘫。在此，我们报告一例罕见的新生儿动脉缺血性中风和脑瘫病例，其由“长骨盆”导致的功能性头盆不称，在分娩过程中胎儿头部受创伤性塑形和顶骨凹陷所致。该患者接受了自体脐带血单个核细胞治疗（45.8毫升，冷冻保存，TNC 2.53×10⁸），恢复显著。每周进行积极的康复治疗。随访检查在3、18、34和57个月时进行。对于分娩过程中出现塑形、颅面畸形和哨兵事件的情况，提倡大量使用新生儿头部磁共振成像，以加强对新生儿脑损伤的诊断，作为包括及时进行自体脐带血移植在内的快速且可能具有病因针对性的治疗方式的基础。
