ABSTRACT
AIMS: Blood clots play the primary role in neurological deficits after germinal matrix hemorrhage (GMH). Previous studies have shown a beneficial effect in blood clot clearance after hemorrhagic stroke. The purpose of this study is to investigate interleukin-19's role in hematoma clearance after GMH and its underlying mechanism of IL-20R1/ERK/Nrf2 signaling pathway. METHODS: A total of 240 Sprague-Dawley P7 rat pups were used. GMH was induced by intraparenchymal injection of bacterial collagenase. rIL-19 was administered intranasally 1 hour post-GMH. IL-20R1 CRISPR was administered intracerebroventricularly, or Nrf2 antagonist ML385 was administered intraperitoneally 48 hours and 1 hour before GMH induction, respectively. Neurobehavior, Western blot, immunohistochemistry, histology, and hemoglobin assay were used to evaluate treatment regiments in the short- and long-term. RESULTS: Endogenous IL-19, IL-20R1, IL-20R2, and scavenger receptor CD163 were increased after GMH. rIL-19 treatment improved neurological deficits, reduced hematoma volume and hemoglobin content, reduced ventriculomegaly, and attenuated cortical thickness loss. Additionally, treatment increased ERK, Nrf2, and CD163 expression, whereas IL-20R1 CRISPR-knockdown plasmid and ML385 inhibited the effects of rIL-19 on CD163 expression. CONCLUSION: rIL-19 treatment improved hematoma clearance and attenuated neurological deficits induced by GMH, which was mediated through the upregulation of the IL-20R1/ERK/Nrf2 pathways. rIL-19 treatment may provide a promising therapeutic strategy for the GMH patient population.
Subject(s)
Cerebral Hemorrhage/drug therapy , Interleukins/therapeutic use , Receptors, Interleukin/agonists , Animals , Animals, Newborn , Cerebral Hemorrhage/congenital , Cerebral Hemorrhage/metabolism , Cerebral Hemorrhage/pathology , Disease Models, Animal , Female , Hematoma/congenital , Hematoma/drug therapy , Hematoma/metabolism , Hematoma/pathology , Interleukins/pharmacology , MAP Kinase Signaling System/drug effects , MAP Kinase Signaling System/physiology , Male , NF-E2-Related Factor 2/metabolism , Rats , Rats, Sprague-Dawley , Receptors, Interleukin/metabolism , Recombinant Proteins/pharmacology , Remission InductionABSTRACT
Biophysical profile (BPP) with ultrasound performed for a 32-year-old G5P3013 admitted at 31 weeks gestation with preterm, premature rupture of membranes (PPROM) noted an extracalvarial mass concerning for an encephalocele. Fetal MRI demonstrated edema over the occiput with no definable lesion visualized. Preterm labor requiring Cesarean delivery resulted in a live male neonate at 33 weeks gestation. An occipital mass was observed on neonatal physical exam. Postnatal ultrasound and MRI were consistent with cephalohematoma. This was surprising given the lack of vaginal delivery. We hypothesize that the occiput was positioned against the maternal ischial tuberosity and developed chronic trauma secondary to normal fetal movement over time, resulting in a cephalohematoma. Postnatal imaging confirmed this diagnosis as the mass gradually decreased and ultimately resolved. Although other etiologies are possible, this case emphasizes the need to consider cephalohematoma in the differential of CNS masses during pregnancy without abdominal trauma and/or vaginal delivery.
Subject(s)
Encephalocele/diagnosis , Fetal Membranes, Premature Rupture , Adult , Birth Injuries/diagnosis , Cerebral Hemorrhage/congenital , Cerebral Hemorrhage/diagnosis , Cesarean Section , Diagnosis, Differential , Female , Hematoma/congenital , Humans , Infant, Newborn , Magnetic Resonance Angiography/methods , Male , Pregnancy , Prenatal Diagnosis/methods , Remission, Spontaneous , Ultrasonography, Prenatal/methodsABSTRACT
Cephalohematomas in newborns are often managed nonsurgically and resolve within the first month of life. In cases of large hematomas (>7 cm) with delayed resorption and persistence over 4 weeks, these masses can often lead to complications of calcification, infection, or hyperbilirubinemia. We report a case of a 14-day-old child with a persistent, large, noncalcified cephalohematoma. After observation alone showed that the cephalohematoma increased in size, 100 ml of old blood was surgically evacuated on day 15 of life. The procedure required a small 1-cm incision and, unlike most large cephalohematomas evacuated after 1 month of observation, there were no signs of skull-deforming calcification observed. This case report presents the earliest evacuation of large noncalcified cephalohematomas in newborns ever reported in the literature, and suggests benefits of early surgical evacuation before 1 month of life.
Subject(s)
Bone Diseases/congenital , Hematoma/congenital , Calcinosis , Humans , Infant, Newborn , SkullABSTRACT
No disponible
Subject(s)
Humans , Male , Penile Erection/genetics , Rupture/complications , Rupture/metabolism , Ambulatory Care/methods , Ambulatory Care/psychology , Hematoma/congenital , Hematoma/complications , Urethral Diseases/pathology , Catheters/classification , Penile Erection/psychology , Rupture/genetics , Rupture/pathology , Ambulatory Care , Ambulatory Care , Hematoma/genetics , Hematoma/metabolism , Urethral Diseases/complications , CathetersSubject(s)
Frameshift Mutation , Gene Deletion , Myopathies, Structural, Congenital/genetics , Protein Tyrosine Phosphatases, Non-Receptor/genetics , Subdural Effusion/genetics , Cerebral Hemorrhage/congenital , Hematoma/congenital , Humans , Infant, Newborn , Male , Myopathies, Structural, Congenital/diagnosis , TwinsABSTRACT
A 4-day-old male infant presented with complaints of jaundice on the third day of life. He was full-term and appropriate for gestational age and born to unrelated parents. All laboratory investigation tests were normal except total serum bilirubin of 27.4 mg/dl with a direct bilirubin 0.29 mg/dl. Abdominal and cranial ultrasonography (US) was performed on sixth day of life because of severe hyperbilirubinemia. Abdominal US revealed adrenal hematoma. Enclosed hematomas may cause significant unconjugated hyperbilirubinemia in absence of other high-risk conditions.
Subject(s)
Adrenal Gland Diseases/congenital , Hematoma/congenital , Jaundice, Neonatal/diagnosis , Adrenal Gland Diseases/complications , Adrenal Gland Diseases/diagnosis , Diagnosis, Differential , Follow-Up Studies , Hematoma/complications , Hematoma/diagnosis , Humans , Infant , Infant, Newborn , Jaundice, Neonatal/etiology , Jaundice, Neonatal/therapy , Male , Phototherapy , Treatment Failure , UltrasonographyABSTRACT
Spontaneously infected cephalohematomas are rare occurrences; only five cases have been reported previously. Uninfected cephalohematomas are common and usually resolve without treatment. However, physicians should be aware that cephalohematomas are potential sites for infection and may require aspiration for diagnosis and treatment. Untreated infected cephalohematomas may lead to osteomyelitis, epidural abscess, or subdural empyema. We present a case of a spontaneously infected cephalohematoma with an associated osteomyelitis which was successfully managed with drainage and long-term antibiotics. A review of the literature is also presented.
Subject(s)
Escherichia coli Infections/congenital , Hematoma/congenital , Occipital Bone , Parietal Bone , Anti-Bacterial Agents , Brain Abscess/diagnosis , Brain Abscess/drug therapy , Drainage , Drug Therapy, Combination/therapeutic use , Escherichia coli Infections/drug therapy , Female , Follow-Up Studies , Hematoma/drug therapy , Hematoma/microbiology , Humans , Infant, Newborn , Magnetic Resonance Imaging , Osteomyelitis/drug therapy , Osteomyelitis/microbiology , Rupture, SpontaneousABSTRACT
We present a case report of a neonate with congenital subperiosteal orbital haematoma presenting with unilateral proptosis with review of current literature. The baby made an uneventful recovery following surgical drainage of the haematoma. This is the second report of orbital haematoma presenting at birth. Orbital haematoma should be considered in the newborn with unilateral proptosis. Early detection with computed tomography (CT) or magnetic resonance imaging (MRI) is required to determine the need for surgical drainage.
Subject(s)
Exophthalmos/etiology , Hematoma/complications , Retrobulbar Hemorrhage/complications , Exophthalmos/congenital , Female , Hematoma/congenital , Humans , Infant, Newborn , Retrobulbar Hemorrhage/congenital , Retrobulbar Hemorrhage/diagnosisSubject(s)
Disseminated Intravascular Coagulation/congenital , Hematoma/congenital , Paraplegia/congenital , Spinal Cord Diseases/congenital , Disseminated Intravascular Coagulation/complications , Disseminated Intravascular Coagulation/diagnostic imaging , Fatal Outcome , Female , Hematoma/diagnostic imaging , Humans , Infant, Newborn , Neurologic Examination , Paraplegia/diagnostic imaging , Spinal Cord Compression/congenital , Spinal Cord Compression/diagnostic imaging , Spinal Cord Diseases/diagnostic imaging , Tomography, X-Ray ComputedABSTRACT
The Authors stress the importance of a correct sonographic study in the follow-up of neonatal adrenal hemorrhage; the diagnostic conclusion are: the best criterion for differential diagnosis is the chronological variability. However the differential diagnosis is rather easy. The differential d. usually is against cystic-neuroblastoma, cortical renal cyst, adrenal abscess. They remark that laparatomy is unnecessary.
Subject(s)
Adrenal Gland Diseases/congenital , Hematoma/congenital , Adrenal Gland Diseases/diagnostic imaging , Diagnosis, Differential , Hematoma/diagnostic imaging , Humans , Infant, Newborn , UltrasonographyABSTRACT
Thoracic spinal cord transection below the origin of the brachial plexus is a rare event among breech-presenting infants delivered by cesarean section. A case of a thoracic (T3-T4) spinal cord injury with paravertebral hemorrhage mimicking catastrophic intracranial bleeding is presented to illustrate the value of careful application of traction or any longitudinal stretching forces during fetal head extraction.
Subject(s)
Birth Injuries , Cesarean Section/adverse effects , Spinal Cord Injuries/congenital , Adult , Breech Presentation , Female , Hematoma/congenital , Humans , Infant, Newborn , Infant, Premature , Pregnancy , Stress, Mechanical , ThoraxSubject(s)
Haemophilus Infections/congenital , Hematoma/congenital , Osteomyelitis/etiology , Parietal Bone/microbiology , Bone Diseases/complications , Bone Diseases/congenital , Fetal Monitoring/adverse effects , Gardnerella vaginalis/isolation & purification , Hematoma/complications , Humans , Infant, Newborn , MaleABSTRACT
Three cases of adrenal hemorrhage requiring surgery are reported in newborn infants. In one case surgery was necessary because of massive retroperitoneal bleeding and in two other cases adrenal neoplasms had been suspected preoperatively. Diagnosis, differential-diagnosis and indication for surgical intervention will be discussed for adrenal hemorrhage in the neonatal period.
Subject(s)
Adrenal Gland Diseases/congenital , Hemorrhage/congenital , Adrenal Gland Diseases/surgery , Adrenal Glands/blood supply , Adrenalectomy , Diagnosis, Differential , Female , Hematoma/congenital , Hemorrhage/surgery , Humans , Infant, Newborn , Infarction , Tomography, X-Ray ComputedABSTRACT
A two-hour-old girl with renovascular hypertension is presented. After aggressive antihypertensive medication, nephrectomy was carried out, but she expired soon after operation. Autopsy revealed intramural haematomas between the media and the adventitia at the centre of both renal arteries where the luminal occlusions were observed.