Intrauterine Fetal Traumatic Brain Injury Following Motor Vehicle Accident; A Case Report and Review of the Literature

Abstract

Trauma, especially traumatic injuries due to car accidents are one of the causes of maternal and fetal mortality and morbidity during pregnancy. Fetus brain injuries are usually caused fetus death. We herein report a pregnant woman in 28 weeks of gestation. The fetus was found to be normal during in-hospital. At birth, the female neonate demonstrated developmental delay and neurological deficits (hypotonicity). Neuroimaging after birth revealed extreme dilatation of lateral ventricles, hypoplasia and aplasia of the brain. In 4 months, she had multiple morbidities including developmental delay, hypotonia, blindness, oropharyngeal dysphagia and simple partial seizure. Motor and response to stimulation was normal. Appropriate seatbelt usage can protect the fetus from sustaining severe intracranial injuries.

Keywords: Fetal injury; Pregnancy; Traumatic brain injury.

Fig. 1

Axial brain CT-scan of the fetus demonstrated multiple skull fracture, interhemispheric SDH, intraparanchymal contusions and hemorrhage, intraventricular hemorrhage and loss of white-gray differentiation

Fig. 2

Sagittal T2-weighted MRI demonstrating the severe encephalomalacia along with brain atrophy (A,B); Axial fluid-attenuated inversion recovery (FLAIR) demonstrating ventriculomegally and multiple intraparanchymal hemorrhages.(C,D,E); coronal T2-weighted MRI demonstrating right frontoparietal brain atrophy