The clinical and radiographic manifestations of trans-tentorial herniation in a neonate. (P6.275)
Bibliographic record
Abstract
Objective: To describe the clinical and radiographic manifestations of trans-tentorial herniation caused by catastrophic intra-cranial bleed in a neonate. Background: Brain herniation is rare in neonates due to the presence of the open fontanels and cranial sutures. The clinical and radiographic findings are rarely described in the literature. Case report: This fetus with intra-uterine growth retardation was born through a cesarean section at 38 weeks of gestation due to fetal distress. He exhibited motor paralysis and focal seizures on the right side as well as apneic seizures which continued despite Phenobarbital. The examination showed bulging of the fontanels and separation of the cranial sutures. He had intermittent periods of brady-cardia and was over-breathing the ventilator at a rate of 30-40 per minute. The pupils were non-reactive and measured 5mm on right and 3 mm on left. Ocular adductions were absent bilaterally. He had flaccid paralysis on the right side and decorticate posturing on the left. The palmar, planter, suck, gag, Moro and tendon reflexes were absent. The parents opted to withdraw support and the baby expired in a few hours. Results: The urine culture was positive for CMV. The blood count showed low platelets of 19,000 necessitating a transfusion. The brain CT demonstrated a large bleeding in the left frontal lobe measuring 30 by 55 mm in diameter, 5 mm of midline shift and extensive suture dehiscence. Extension of the blood into the ventricles, subdural and subarachnoid space was noted. Discussion: The clinical findings in this case represent unchal herniation at the late third nerve stage. Neurogenic hyperventilation is caused by mechanical compression of the mesencephalon. Direct compression of the ipsilateral cerebral peduncle and the third nerve by the unchus and the contralateral ones against the tentorial edge produce diplegia and varying degrees of third nerve dysfunction.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.003 |
| Meta-epidemiology (narrow) | 0.001 | 0.001 |
| Meta-epidemiology (broad) | 0.001 | 0.001 |
| Bibliometrics | 0.002 | 0.001 |
| Science and technology studies | 0.001 | 0.001 |
| Scholarly communication | 0.001 | 0.001 |
| Open science | 0.001 | 0.001 |
| Research integrity | 0.003 | 0.002 |
| Insufficient payload (model declined to judge) | 0.003 | 0.001 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".