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Journal of Child Neurology, Vol. 22, No. 3, 354-357 (2007)
DOI: 10.1177/0883073807300539

Necrotic Skin Lesions and Cerebral Infarction in the Newborn: Two Case Reports

Nathalie Bednarek, MD

Department of NICU, Hôpital Alix de Champagne. Reims, France, nbednarek{at}chu-reims.fr

Patrice Morville, PhD

Department of NICU, Hôpital Alix de Champagne. Reims, France

Glwadys Delebarre, MD

Department of NICU, Hôpital Alix de Champagne. Reims, France

Ahmad Akhavi, MD

Department of NICU, Hôpital Alix de Champagne. Reims, France

Christelle Sommer, MD

Department of NICU, Hôpital Alix de Champagne. Reims, France

Localized skin necrosis with deeper soft tissue injury at birth is unusual and has been rarely reported in association with cerebral infarction. Two cases with forearm necrotic skin associated with injured deeper soft tissue are described in which brachial artery thrombosis was documented. Considering the possibility of disseminated thrombosis, cerebral ultrasound showed brain infarction due to unilateral middle cerebral artery thrombosis on Doppler. The origin of the embolism was identified in the inferior vena cava and umbilical and portal vein. No thrombophilia or other risk factors were identified. The various causes of the cutaneous lesions pointed to an antenatal process whose etiology and mechanisms are discussed. Localized necrotic skin lesions must be considered as part of a systemic embolic process and can lead to extensive especially cerebral ultrasound exploration.

Key Words: newborn • skin necrosis • cerebral infarction • cerebral palsy


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