Deep Medullary Veins and Brain Injury

A term male neonate appropriate for gestational age was admitted to the neonatal intensive care unit with large bilateral inguinal hernias. He was the first twin of nonconsanguineous parents born by caesarean delivery after an uneventful assisted reproductive technology pregnancy. At day 6 of life he presented with fever, irritability, bulging anterior fontanelle, and seizures while awaiting surgery. A laboratory workup revealed elevated C-reactive protein and pleocytosis, high protein, and low glucose levels in cerebrospinal fluid (CSF).

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