Cerebral Intraparenchymal Hemorrhage Presenting as Global Myocardial Hypokinesia in Term Newborn: A Case Report

Abstract

Background: Intracranial hemorrhage (ICH) in neonate has devastating morbidity and long term sequel. The most common presentation of ICH is seizures. We present a rare case of ICH presenting as severe myocardial dysfunction termed as neurogenic stunned myocardium (NSM) in a neonate due to traumatic vaginal delivery which recovered completely with inotropic support. Case Report: A day one male neonate presented with respiratory distress soon after birth, which resolved following noninvasive respiratory support. Later developed shock requiring mechanical ventilation and inotropic support. Echocardiography showed severe myocardial hypokinesia with low ejection fraction. On neurosonogram, neonate had diffuse intraparenchymal cerebral hemorrhages in multiple parts of cerebral cortex. This baby recovered completely with inotropic support and mechanical ventilation. This myocardial dysfunction due to neurological insult is termed as neurogenic stunned myocardium. Conclusion: NSM is rarely reported in neonates. NSM should be kept in differential diagnosis of neonate who presents with myocardial dysfunction, following neurological insult which is reversible with supportive care.