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PARTICULAR MORPHOPATHOLOGICAL ASPECTS

OF THE NEWNEW-BORN'S CEREBRAL HEMORRHAGE


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It occurs in hypoxic-ischemic complex brain injuries and not as an obstetric


mismanagement of term birth anoxia.
We consider that most cases of neonatal hypoxic-ischemic encephalopathy have
antenatal insults, difficult to pinpoint. We already can be sure about a great
number of vasculopathy alteration, such as :
[changes in the blood flow direction in circle of Willis;
[ decreased blood-flow velocity in the veins;
[changes in the flow of the riht vertebral artery, with isolated hemorrhagic
lesions;
[neonatal thrombotic vessels;
[vessels occlusion by an embolus with obstruction of the middle cerebral
artery.

This study pinpoint that the u u  


 u u 
    , to a important cohort of neonatal death, especially
premature.

STUDY
YEARS

PREMATURES

2002

(from all newborns)

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AGE AT DEATH (days)

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1 -7

8 -14

15 - 21

22 - 30

16

19

2003

22

21

2005

19

14

2006

15

16

2007

12

12

105

106

28

14

TOTAL

 

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( ()*(&*( +* |* ( |*,('&'*-|',-*|*|(* ||()*


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a 
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,
 0  %
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1
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 :

42 ;
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YEAR

'|& '

ASTROCITE
intens

absence

MICROGLIAL
CELLS
intens

H&E

2/2002

GFAP

4/2003

Prot.
S -100

4/2005

CD68

10/2006

Vim
(entin)

11/2007

TOTAL

31

intens

ASTROCITE
intens

intens

 

NEURONAL
DEATH
intens

absence

+
|&*/ ,

 

+
+

|&*/ ,

+
+

absence

+
+

absence

MICROGLIAL
CELLS

+
+

absence

+
+

absence

NEURONAL
DEATH

+
3

Immunohistochemistry

( . 4  ',(*')+|

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& 4
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CHOROID PLEXUS AND


EPENDIMA

BRAIN SAMPLES

STUDY

MARKER
CASES/
USED

MACROSCOPIC LESIONS AT AUTOPSIES


STUDY
YEARS

(
. 
',(*')+||('('&|&*/
,
Cortical
infarcts
Multifocal
Choroid plexus Germinal matrix

and petechial
white-matter
hemorrhage

hemorrhagic
white-matter
infarcts

and
subependymal
thrombosis

and
intraventricular
hemorrhage

2002

14

15

12

2003

17

18

15

2005

16

14

2006

15

16

11

2007

10

10

91

38

86

78

|('  


|(' 

TOTAL
(  PARTICULAR

MACROSCOPICAL ASPECTS OF NEONATAL CEREBROVASCULAR


INJURIES THEY ARE OFTEN ASSOCIATED AND VARIABLE

DISCUSSION
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