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Thread: Rare - Blood in spinal cord, no trauma in 4 month old

  1. #1

    Rare - Blood in spinal cord, no trauma in 4 month old

    Hello

    In Sept of 2011 I gave birth pre-maturely to my son Dwayne. He was born at a weight of 1lb 4oz. His growth journey had many obstacles including what doctors thought was NEC an infection in his belly in November. During this period he had became critically ill and was very swollen. I noticed that my baby was not moving his hands as much as normal and he was quite unresponsive. After my repeated concern, questions and complaints to the doctors there was finally a spinal tap done to check for any possible infection causing his lack of movement. When this was done (Dec 11) the fluid that was extracted was bloody. Now doctors decided to do an MRI, this revealed that somehow blood was in my sons spinal cord. In and not around such as in the case o hematoma. The results show the brain stem and apparently area C-5 I belive was affected. A follow up MRI was done roughly 2 weeks ago showing there has not been much change. The entire medical staff admits that they are not sure how this has happened, how it is to be treated nor what to expect going forward. So this is where we would love assistance. Have you or anyone on your team ever experienced or read studies regarding a pre-term infant with internal cord bleeding? With my approval the doctors will provide images of the MRI and any information that would be helpful if your are willing to help find a cure or provide any information which could be useful in having a better understanding in the treatment of my baby. I would greatly appreciate your insight regarding this matter! I love my baby and after 4months in the NICU he has suffered and fought enough and I want help in finding him a cure.

  2. #2
    So sorry, Angel. I will ask Dr. Young to comment. I suspect that your son may have had a bleed from a congenital spinal cord blood vessel hemorrhage. Did they do an angiogram or other tests to look for an AVM or aneurysm?

    (KLD)

  3. #3
    Actually I was told that my sons is not yet a candidate for such test as he is still on ventilator and just now 4lbs 3oz. I just so happened to ask the dr yesterday could all of this be a result of anyerism and the doctor says they feel it could have been a ventrical malformation. Everything is just an assumption at this point as they are not sure what's going on. Do you know if blood in the spinal cord will reabsorb into the body and is there some kind of timeline?

  4. #4

    Recovery

    In Sept of 2011 I gave birth pre-maturely to my son Dwayne. He was born at a weight of 1lb 4oz. His growth journey had many obstacles including what doctors thought was NEC an infection in his belly in November. During this period he had became critically ill and was very swollen. I noticed that my baby was not moving his hands as much as normal and he was quite unresponsive. After my repeated concern, questions and complaints to the doctors there was finally a spinal tap done to check for any possible infection causing his lack of movement. When this was done (Dec 11) the fluid that was extracted was bloody. Now doctors decided to do an MRI, this revealed that somehow blood was in my sons spinal cord. In and not around such as in the case o hematoma. The results show the brain stem and apparently area C-5 I belive was affected. A follow up MRI was done roughly 2 weeks ago showing there has not been much change. The entire medical staff admits that they are not sure how this has happened, how it is to be treated nor what to expect going forward. So this is where we would love assistance. Have you or anyone on your team ever experienced or read studies regarding a pre-term infant with internal cord bleeding? With my approval the doctors will provide images of the MRI and any information that would be helpful if your are willing to help find a cure or provide any information which could be useful in having a better understanding in the treatment of my baby. I would greatly appreciate your insight regarding this matter! I love my baby and after 4months in the NICU he has suffered and fought enough and I want help in finding him a cure.

    Actually I was told that my sons is not yet a candidate for such test as he is still on ventilator and just now 4lbs 3oz. I just so happened to ask the dr yesterday could all of this be a result of anyerism and the doctor says they feel it could have been a ventrical malformation. Everything is just an assumption at this point as they are not sure what's going on. Do you know if blood in the spinal cord will reabsorb into the body and is there some kind of timeline?

    Angel,

    There are many causes of hemorrhage in the brain and spinal cord. These range from arteriovenous malformations and aneurysms to infections, strokes, and trauma. The fact that blood was found on a spinal tap does not necessarily mean that the hemorrhage occurred in the spinal cord. It could have occurred anywhere in the brain or spinal cord and still show up in the cerebrospinal fluid taken from a spinal tap. An infection can cause a stroke and hemorrhage. A loss of clotting factors (because your baby was so sick) could have caused bleeding in the brain or spinal cord. Whenever there is an arteriovenous malformation, i.e. where arteries may connect inappropriately with veins, venous pressure increases and a network of tortuous and swollen veins may develop. Any breakage or leakage of these veins can cause hemorrhage. A clot that enters the blood vessels of the brain or spinal cord damage the blood vessels and hemorrhage can result. The cause(s) of brain and spinal cord hemorrhage frequently cannot be determined.

    The important question is what can and should be done about the hemorrhage that was found. If a hematoma is growing and compressing the brainstem or spinal cord, an operation should be done to aspirate the hematoma and relieve the compression. However, your description of the MRI findings suggests that the hemorrhage is inside the spinal cord and in the brainstem, rather than a hematoma. Unless it is still bleeding and expanding, operation on a hemorrhage inside the brain or spinal cord is usually not helpful and cause more damage. This is particularly true of the brainstem and cervical spinal cord. The fact the hemorrhage has not changed in the most recent MRI suggests that it is not continuing to bleed. If so, the best decision is to leave it alone and hope that it will resolve and your baby recovers as much as possible. Yes, the brain and spinal cord will eventually clean up and remove clots. Both the brain and blood have cells called macrophages that will gobble up the clot and dead cells. Operating and removing the blood will cause more damage to the surrounding brainstem and spinal cord.

    What does C5 spinal cord and the brainstem do? The C5 cord controls the upper arm, i.e. the biceps. The C4 cord controls the deltoids (shoulder) and contains part of the phrenic nucleus (the nucleus that controls breathing). The C6 spinal cord controls the wrist extensors. The brainstem controls many functions including the VII, VIII, IX, X, XI, XII cranial nerves. Depending on where the brainstem hemorrhage is, it may affect facial movement (VII), vestibular system (VIII), vagal (X), swallowing (XI), and sternocleidomastoid muscle that turns the neck (XII). Is your baby on a respirator? If he is not, he is very lucky because hemorrhage in the cervical spinal cord and brainstem may damage the centers that control breathing.

    What should you expect in terms of recovery? The hemorrhages will resolve. Both the brainstem and spinal cord are amazingly resilient. As little as 10% of the spinal cord can support much function. Most kids recover substantially from brainstem infarcts, if they do recover at all. Shortly after injury, function may be absent for many weeks or even months but will gradually recover. It is hard to predict how much will recover, particularly in a premature baby. However, much function, including moving of the legs and use of one or both arms may happen. The phrenic nucleus is very plastic and can regrow connections that may allow breathing to occur again. However, it is hard to predict and further strokes or hemorrhages would be devastating.

    Therefore, your son’s doctors should be doing everything that they can to prevent any further brain and spinal cord damage, and hope. At the present, we don’t have any proven therapies that have been proven to accelerate or increase the extent of recovery in children, except for activity. If you have any questions, please ask.

    Wise.

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