Question

My son is three days old, weighing 7.5 pounds after cesarean section, and all his vital signs are normal. The afternoon of the first day after birth, we noticed a small hematoma on the right side of his head. The doctor said to observe for two days and it didn’t get bigger. The CT scan said there was mild hypoxic-ischemic encephalopathy. Do I need to treat it? Thank you.

Answer

I’ve never heard of neonatal hypoxic-ischemic encephalopathy before, and relying solely on a CT scan to diagnose HIE is not enough. The doctor needs to consider clinical symptoms such as irritability or seizures. You can ask the attending physician if the child has any clinical symptoms. Moreover, the child was in good condition at birth and was full-term, without any high-risk factors for HIE. Therefore, there is still some doubt about the diagnosis. Personally, I believe that an MRI scan would provide a clearer view of the low-density focus on the CT. In the future, it should be part of a follow-up program to observe for any signs of ventriculomegaly or white matter softening.