PERSISTENT RESPIRATORY-FAILURE DUE TO LOW CERVICAL CORD INFARCTION INNEWBORN BABIES

Perinatal infarction of the spinal cord is described in two premature babies who survived for several months. In both cases, there was bilat eral, multisegmental infarction at the lower cervicothoracic arterial zone (inferior cervical sector), predominantly within the territory of the anterior spinal artery. Clinically, both infants had acute respir atory failure, diaphragmatic respiration, intercostal paralysis, bell- shaped deformity of the thorax, and bilateral arm paresis. Intubation and ventilator support were required for weeks. Eventual extubation wa s followed by recurrent respiratory failure, atelectasis, and pneumoni a. At the level of the infarction, multiple, scattered scars were foun d in central, perimedullary, and intramedullary arteries, but not in t heir parent vessels. The etiology of the angiopathy was not determined . These cases demonstrate that discrete arterial infarction of the cor d can occur in premature babies, and that such a lesion should be cons idered in the differential diagnosis of neonatal respiratory failure.