Cohen M, Roessmann U
Institute of Pathology, Case Western Reserve University, Cleveland, OH 44106.
Dev Med Child Neurol. 1994 Mar;36(3):263-8. doi: 10.1111/j.1469-8749.1994.tb11839.x.
The authors examined the brains of two infants in whom episodes of fetal compromise could be accurately correlated with gestational age. A mother who had sustained hypotensive shock at 16 weeks gestation gave birth at 20 weeks to a stillborn infant whose brain showed cystic necrosis of the lenticular nuclei and multifocal polymicrogyria. The brain of a seven-month-old infant born at 33 weeks gestation to a mother who had experienced respiratory arrest during her 28th week showed thalamic and brainstem necrosis accompanied by diffuse white matter gliosis. Review of the literature yielded 10 similar cases. When the insults occurred before 24 weeks of gestation, bilateral pallidal necrosis was a constant feature. Between 26 and 34 weeks, the common finding was thalamic necrosis, often accompanied by brainstem necrosis. These observations should be of assistance in determining the timing of gestational insults, and therefore possible clinical correlations, in prenatal brain damage.
作者检查了两名婴儿的大脑，这两名婴儿的胎儿窘迫发作能与孕周精确关联。一名在孕16周时遭受低血压休克的母亲，在孕20周时产下一名死产婴儿，其大脑显示豆状核囊性坏死和多灶性多小脑回。一名在孕33周出生的7个月大婴儿，其母亲在孕28周时经历了呼吸骤停，该婴儿的大脑显示丘脑和脑干坏死，并伴有弥漫性白质胶质增生。文献回顾发现了10例类似病例。当损伤发生在孕24周之前时，双侧苍白球坏死是一个恒定特征。在26至34周之间，常见的发现是丘脑坏死，常伴有脑干坏死。这些观察结果应有助于确定产前脑损伤中孕期损伤的时间，以及因此可能存在的临床关联。
