Neonatal acquired paraplegia: retrospective review of 30 patients.
Thirty patients with neonatal acquired paraplegia without an identified cause were reviewed. The mean gestational age was 33 weeks (range, 25-40 weeks); the mean Apgar scores were 6 and 8 (range, 0-10); the mean weight at birth was 1.739 kg (range, 0.750-4.200 kg). Half of the infants needed neonatal intensive care for a mean period of 42 days. Fourteen (46%) had local or generalized infections, 12 (40%) had respiratory complications, and seven (22%) required mechanical ventilation. Seven (22%) had polycythemia, six (20%) had anemia, six (20%) underwent umbilical artery catheterization, and five (16%) received full exchange transfusion. Two clinical presentations were observed: flaccid (24 patients) and hypertonic (6 patients). The secondary deformities that were found and the orthopedic procedures to correct them are described. A vascular or intravascular change, such as thrombosis/embolism or ischemia/hypoxia by vasospasm or failure of autoregulation of spinal blood perfusion, is the final pathway of many events that may produce paraplegia in preterm and low birthweight neonates.
Arendar
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G
National Pediatric Hospital Juan P. Garrahan, Buenos Aires, Argentina.
Samara
E
E
Palmas
C
C
D000740:Anemia / Q000209:etiology; D001034:Apgar Score; D005078:Exchange Transfusion, Whole Blood; D005260:Female; D005865:Gestational Age; D006617:Hip Dislocation / Q000000981:diagnostic imaging / Q000209:etiology / Q000601:surgery; D006801:Humans; D007231:Infant, Newborn; D015931:Intensive Care, Neonatal; D008297:Male; D019637:Orthopedic Procedures; D010264:Paraplegia / Q000175:diagnosis / Q000209:etiology / Q000628:therapy; D011086:Polycythemia / Q000209:etiology; D011379:Prognosis; D011859:Radiography; D012121:Respiration, Artificial; D012189:Retrospective Studies; D013923:Thromboembolism / Q000150:complications; D016896:Treatment Outcome