Birth trauma

In term infants, acute hypoxic-ischemic injury and birth trauma appear to be more significant events in the evolution of brain injury (64). It has been widely recognized, however, that although many neonates who ultimately develop CP sustain their injury during birth or in the NICU, most CP patients do not have evidence of acute neonatal events capable of producing permanent injury (65-67). In term neonates, the large majority of infants with CP have no clearly discernible asphyxial event to which the injury can be attributed. 

Evaluation reveals an edematous, thickened, usually hazy cornea with bullae (Figure 26-12). Some areas of the cornea stain with NaFl due to ruptures of the bullae. Focal involvement of the cornea is possible, especially if there has been local disruption such as birth trauma or foreign body injury. 

This patient safety indicator is concerned with birth trauma (injury to neonate) and is expressed by... 

Oi5 = the number of intracranial hemorrhage, extraclavicular fracture, spinal injury, nerve injury (other than facial and brachial plexus), and other birth trauma. 

Cumming WA (1979) Neonatal skeletal fractures. Birth trauma or child abuse J Can Assoc Radiol 30 30-33 Curran JS (1981) Birth associated injury. Clin Perinatol 8 111-19 Dahlenburg SL, Bishop NJ, Lucas A (1989) Are preterm infants at risk for subsequent fractures Arch Dis Child 64 1384-1393... 

It can be more difficult to clinically assess an infant or young child than an adult and a multidisciplinary approach is indicated. A careful clinical evaluation is needed if there is a history of facial or head trauma, loss of consciousness, high speed motor vehicle accident, or birth trauma. A radiological examination should be undertaken in these circumstances and when there is an abnormality on neurological examination. The type of radiological investigation depends on the nature of injury and the clinical findings. 

After birth, a rapid drop in progesterone level initially triggers lactation through reversal of inhibitory effects on prolactin (Fig. 44-2). Nipple stimulation then enables lactation to continue once established. During lactation, ineffective removal of milk from the breast, trauma, and skin breaks may lead to problems such as milk stasis, nipple pain, and mastitis.12 Additionally, some women have difficultly initiating lactation due to improper technique and/or activity of inhibitors such as dopamine (Fig. 44-2). 

Epilepsy (or epilepsies, since markedly different clinical entities exist) is a common neurological abnormality affecting about 1% of the human population. Epilepsy is a chronic, usually life-long disorder characterized by recurrent seizures or convulsions and usually, episodes of unconsciousness and/or amnesia. Table 32.1 illustrates the major types of epileptic seizures. Patients often exhibit more than one type. In most instances, the cause of the seizure disorder is not known (idiopathic epilepsy), although trauma during birth is suspected of being one cause. 

The prevalent theory among both health professionals and the general public today is that the symptoms of ADHD have a biological cause. The most generally cited causes are birth defects, an infant trauma, and the brain s inability to produce enough of specific neurotransmitters, or brain chemical messengers. 

Medical history—low K BP with pregnancy birth control pills (BCP) licorice over the counter (OTC) phrine renal trauma episodes of HTN inferring pheochromocytoma, that is, headache hyperhidrosis high heart rate hypermetabolism, etc. 

Multiple sclerosis Preganglionic Spinal birth injury Tuberculosis Pancoast tumor Aortic aneurysm Enlarged mediastinal glands Enlargement of thyroid Lymphadenopathy Thoracic neuroblastoma Pulmonary mucormycosis Trauma... 

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