Additional pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com
Michael P. D'Alessandro, M.D.
Peer Review Status: Internally Peer Reviewed
Clinical History:
The patient was a 17 month old female who fell down 12 steps in her
grandmother's arms with the grandmother landing on the child's head
and smothering her.
Clinical Physical Exam:
The patient had abnormal posturing and a blown left pupil.
Clinical Labs:
Non-contributory
Clinical Differential Diagnosis:
Diffuse cerebral edema
Imaging Findings:
Chest film showed air in the mediastinum. Head CT exam showed diffuse
cerebral edema and left contusion, subarachnoid hemorrhage, a frontal
skull fracture, and air dissecting in the neck. An abdomen CT exam
showed air in the mediastinum and a small right pneumothorax.
Imaging Differential Diagnosis:
Pneumomediastinum
Operative Findings:
None
Pathological Findings:
None
Final Diagnosis:
Pneumomediastinum
Follow-up and Prognosis:
The patient was felt to be brain dead and had a nuclear medicine
brain scan which confirmed the diagnosis. She was taken off of life
support and died.
Similar Cases:
None
References:
Additional pediatric resources: GeneralPediatrics.com | PediatricEducation.org | SearchingPediatrics.com
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