This book focuses on traumatic birth injuries, predominantly of the skull and brain, as well as hemorrhagic and ischemic disorders of cerebral circulation in fetuses and newborns, providing information on each condition’s classification, incidence, etiology and pathogenesis, pathomorphology, clinic, diagnostics, prognosis, and complications. It discusses the configuration (molding) of the head, venous congestion, displacements of cranial bones, ruptures of the cerebellar tentorium during labor, and the compression of the skull and brain damage caused by obstetric operations and asynclitic insertion of the head, while also describing the importance of the periosteal stagnation of the skull to assess the delivery and explanation of tentorium tears. Intracranial hemorrhages are considered in detail, taking into account the role of the traumatic factor in their occurrence and hypoxic-ischemic brain lesions (periventricular leukomalacia, selective neuronal necrosis, multicystic encephalomalacia, etc.). Lastly, it offers the world’s first explanation of why tentorium tears occur most frequently in the left half, providing an original classification of damaged tentoria, subarachnoid and intraventricular hemorrhages, and the degree of configuration of the head in childbirth. Given the depth and breadth of its coverage, the book offers an essential resource for neonatologists, obstetricians-gynecologists, perinatologists, pediatric neurologists, pathologists, pediatricians, forensic experts and neuroimaging professionals.

Haemorrhage, Ischaemia and the Perinatal Brain focuses on an area of major importance in perinatal medicine. The authors, who have both made significant contributions to the subject of cerebral haemorrhage in the newborn, put forward many new and unpublished ideas throughout this monograph. By presenting a synopsis of current knowledge on all aspects of the haemorrhagic and ischaemic lesions affecting the newborn brain, they aim to provide the clinician with a logical basis for management of these devastating conditions and attempts at their prevention. The influence of altered cerebral circulatory physiology on the developing vasculature is emphasized as the key to understanding the patterns of pathology that occur at different gestational ages. A feature of the book is the chapter on vascular anatomy of the developing brain, which contains extensive new and original work illustrated in colour. Cerebral circulatory physiology, birth trauma, ischaemic lesions of the preterm and term brain damage all receive coverage, in addition to a comprehensive series of chapters on intraventricular haemorrhage. Sections on clinical management are illustrated by radiographs and CT scans from the Department of Radiology, Hospital for Sick Children, Toronto, and there are original line drawings by the authors throughout the book. Although intended primarily for the paediatrician, this book should also be of particular interest to pathologists, obstetricians and all whose work is concerned with perinatal care.

Decision making in modem obstetrics and perinatology is con trolled by a variety of different factors, but there is little doubt that in industrialized countries one of the most powerful single factors is the concern and fear of causing permanent brain damage in the unborn and newborn. The dramatic increase in the rates of abdom inal deliveries in many parts of the world is certainly rooted to a substantial part in the ~bstetrician's concern not so much about possible perinatal death, but more so about permanent brain dam age in surviving children. This trend has been accelerated by the increasing number of litigations in connection with brain damage observed in many societies. This problem itself has many aspects, but it seems evident that litigation - justified or unjustified - is one modem expression of the human and social tragedy inflicted on individuals and families by the birth of a brain-damaged child. The medical, social, and human importance of the problem is in sharp contrast to the relative lack of scientific knowledge avail able. This became very clear when the National Institutes of Health published the excellent review in 1985 on "Prenatal and Perinatal Factors Associated with Brain Disorders" and its editor, J. M.

The investigation of sudden or unexplained death of children represents a unique medical and forensic area of study. Children have unique anatomic and functional characteristics that must be recognized and understood by the medical investigator. Further complicating this process is the fact that the anatomic structure, composition and function of various organs and organ systems in the pediatric population change throughout the developmental stages of childhood. The disease processes, reactions to trauma and risk factors for accidental death and homicide change from infancy through adolescence. Forensic Pathology of Infancy and Childhood provides an authoritative, comprehensive reference text devoted to the medicolegal investigation of sudden unexpected death in children. With contributions from internationally renowned experts, individual chapters focus on specific unique causes and organ systems with detailed accounts of the changes in fatal diseases, risk factors of causes of sudden death, and responses to fatal trauma that occur as a child grows from neonatal stage through infancy, toddlerhood, childhood and adolescence. This text is an essential reference resource for forensic pathologists, medical examiner offices, pediatric pathologists, pediatric hospitals, anatomic pathologists and those in training as well as those in related legal professions.

Now in its third edition, this is a comprehensive survey of fetal and neonatal brain injury arising from hypoxia, ischemia or other causes. The volume spans a broad range of areas from epidemiology and pathogenesis, through to clinical manifestations and obstetric care, and then on to diagnosis, long-term outcomes, and medico-legal aspects. An important theme running throughout is to highlight scientific and clinical advances that have a role to play in minimising risk, improving clinical care and outcomes.

It is estimated that the functionally significant body of knowledge for a given medical specialty changes radically every 8 years. New specialties and "sub-specialization" are occurring at approximately an equal rate. Historically, established journals have not been able either to absorb this increase in publishable material or to extend their readership to the new specialists. International and national meetings, symposia and seminars, workshops and newsletters, successfully bring to the attention of physi cians within developing specialties what is occurring, but generally only in demonstration form without providing historical perspective, patho anatomical correlates, or extensive discussion. Page and time limitations oblige the authors to present only the essence of their material. Pediatric neurosurgery is an example of a specialty that has developed during the past 15 years and over this period, neurosurgeons have ob tained special training in pediatric neurosurgery and then dedicated them selves primarily to its practice. Centers, Chairs, and educational pro grams have been established as groups of neurosurgeons in different countries throughout the world organized themselves respectively into national and international societies for pediatric neurosurgery. These events were both preceded and followed by specialized courses, national and international journals, and ever-increasing clinical and investigative studies into all aspects of surgically treatable diseases of the child's ner vous system.