<abstract xmlns="http://www.w3.org/1999/xhtml"><p> Background: Cerebellar hemorrhage is a rare but serious perinatal condition with various etiologies leading to fetal and neonatal death and adverse neurological complications. Complete autopsy and placental examination are essential for identification of a cause of the bleeding. Objective: Present a case of cerebellar hemorrhage in utero associated with ‘massive’ fetal thrombotic vasculopathy (FTV). Method: Autopsy of a stillborn female fetus, 26 weeks gestation, with intrauterine growth restriction, delivered by a 37-year-old woman. Results: The fetus showed multiple recent peticheal hemorrhages along the cerebellar cortex. The placenta revealed a large thrombosed chorionic blood vessel. Microscopic findings showed multiple vascular thrombosis and massive FTV throughout the placental villi. These were recognized as two histologic patterns, ‘early’ stromal karryorhxis, and ‘late’ villous stromal involution. Conclusion: Massive FTV was a leading cause of fetal stress due to increased resistant of downstream placental villi. This longstanding stressful environment induced auto-regulation impairment of fetal cerebral blood flow resulting in cerebellar parenchymal bleeding. Careful placental examination is beneficial for understating the mode and mechanism of fetal death.</p></abstract>

Background: Cerebellar hemorrhage is a rare but serious perinatal condition with various etiologies leading to fetal and neonatal death and adverse neurological complications. Complete autopsy and placental examination are essential for identification of a cause of the bleeding. Objective: Present a case of cerebellar hemorrhage in utero associated with ‘massive’ fetal thrombotic vasculopathy (FTV). Method: Autopsy of a stillborn female fetus, 26 weeks gestation, with intrauterine growth restriction, delivered by a 37-year-old woman. Results: The fetus showed multiple recent peticheal hemorrhages along the cerebellar cortex. The placenta revealed a large thrombosed chorionic blood vessel. Microscopic findings showed multiple vascular thrombosis and massive FTV throughout the placental villi. These were recognized as two histologic patterns, ‘early’ stromal karryorhxis, and ‘late’ villous stromal involution. Conclusion: Massive FTV was a leading cause of fetal stress due to increased resistant of downstream placental villi. This longstanding stressful environment induced auto-regulation impairment of fetal cerebral blood flow resulting in cerebellar parenchymal bleeding. Careful placental examination is beneficial for understating the mode and mechanism of fetal death.

Cerebellar hemorrhage in utero associated with ‘massive’ fetal thrombotic vasculopathy

Asian Biomedicine

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Background: Cerebellar hemorrhage is a rare but serious perinatal condition with various etiologies leading to fetal and neonatal death and adverse...

Cerebellar hemorrhage in utero associated with ‘massive’ fetal thrombotic vasculopathy

Published Online: Apr 13, 2018

Page range: 781 - 786

DOI: https://doi.org/10.2478/abm-2010-0101

Keywords
Cerebellar hemorrhage, fetal stroke, fetal thrombotic vasculopathy

© 2018

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Cerebellar hemorrhage in utero associated with ‘massive’ fetal thrombotic vasculopathy

Published Online: Apr 13, 2018

Page range: 781 - 786

DOI: https://doi.org/10.2478/abm-2010-0101

KeywordsCerebellar hemorrhage, fetal stroke, fetal thrombotic vasculopathy

© 2018

This work is licensed under the Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 License.

Keywords
Cerebellar hemorrhage, fetal stroke, fetal thrombotic vasculopathy