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Special Feature
October 1999

Radiological Case of the Month

Author Affiliations

From the Department of Neonatal and Pediatric Intensive Care, Center for Pediatrics, Medical Faculty of Otto-von-Guericke-University (Drs Avenarius and Föhe), Walter-Friedrich-Hospital (Drs Schultz and Canzler), Magdeburg, Germany; and the Department of Radiology, University of Southern California School of Medicine, Los Angeles (Dr Wood).



Arch Pediatr Adolesc Med. 1999;153(10):1103-1104. doi:10.1001/archpedi.153.10.1103

DURING A ROBBERY a 19-year-old woman in her 29th week of pregnancy was stabbed in the lower abdomen. Two hours later, an emergency cesarean delivery was performed. Blood was present in the amniotic fluid. The Apgar scores were 2/5/6 at 1, 5, and 10 minutes, respectively. Above the right ear was a 2-cm-long bleeding wound. The neonate had stable respiratory and hemodynamic functions. The cerebral sonogram showed an extensive intracerebral hemorrhage in the region of the right thalamus and temporal lobe with a visible 5- to 6-cm-long incision channel (Figure 1) stretching about 1 cm beyond the midline. A large, right-sided subdural hematoma near the laceration site and intraventricular bleeding had occurred.

A cranial computed tomographic scan confirmed the incision channel and fresh bleeding (Figure 2). Surgical evacuation of a subdural hematoma was undertaken. Serial cranial sonography revealed right hydrocephalus and absence of the right thalamus and a small right choroid plexus, apparently excised by the knife (Figure 3). After age 6 months, left spastic hemiparesis, an abducted position of the left leg, and external rotation of the left hand developed.