Volume 10, Issue 1 (3-2024)
CJP 2024, 10(1): e9 |
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Neelam H, kotha R, Madireddy A. A Late Presentation of Neonatal Axial Hypotonia due to Craniovertebral Anomaly. CJP 2024; 10 (1)
URL: http://caspianjp.ir/article-1-240-en.html
URL: http://caspianjp.ir/article-1-240-en.html
Department of Neonatology, Niloufer Hospital, Hyderabad, India , dr.rakeshkotha@gmail.com
Abstract: (353 Views)
Background and Objective: Basilar invagination and atlas assimilation are significant craniovertebral anomalies that typically present with symptoms in the 3rd and 4th decades of life. These anomalies are concerning because they are in close proximity to the vital structures surrounding the foramen magnum, including the brainstem and spinal cord. However, these conditions are rarely reported in younger populations, making early diagnosis and intervention in such cases particularly difficult.
Case Report: This report presents the case of a term neonate born to a primigravida mother by emergency lower segment cesarean section. The infant, who was initially discharged after resolution of respiratory distress, was readmitted at two weeks of age with generalized weakness. The initial management approach focused on treating the condition as late-onset sepsis and meningitis. However, after ruling out other causes for the generalized hypotonia, subsequent computed tomography (CT) of the head and spine revealed compressive myelopathy secondary to basilar invagination and atlas assimilation, as well as gross hydrocephalus. These findings emphasize the presence of a craniovertebral anomaly at an exceptionally early stage of life.
Conclusions: This case highlights the importance of recognizing this congenital anomaly to ensure an early and accurate neuroimaging. A thorough clinical history combined with a comprehensive neurological examination is essential for prompt management, which can significantly improve outcomes in such rare presentations.
Case Report: This report presents the case of a term neonate born to a primigravida mother by emergency lower segment cesarean section. The infant, who was initially discharged after resolution of respiratory distress, was readmitted at two weeks of age with generalized weakness. The initial management approach focused on treating the condition as late-onset sepsis and meningitis. However, after ruling out other causes for the generalized hypotonia, subsequent computed tomography (CT) of the head and spine revealed compressive myelopathy secondary to basilar invagination and atlas assimilation, as well as gross hydrocephalus. These findings emphasize the presence of a craniovertebral anomaly at an exceptionally early stage of life.
Conclusions: This case highlights the importance of recognizing this congenital anomaly to ensure an early and accurate neuroimaging. A thorough clinical history combined with a comprehensive neurological examination is essential for prompt management, which can significantly improve outcomes in such rare presentations.
Type of Study: case report |
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