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We present a case of brain abscess necroptically discovered in a 2-year-old child hospitalized in the Pediatrics Clinic of the "Filantropia" Municipal Hospital, Craiova, Romania. The family, with a poor financial situation, reports previous episodes that may be interpreted as comitial crises. Clinically speaking, he presents a height-weight hypertrophia, vitamin D loss rickets, and psychomotor retardation. At the objective examination, we found a weight of 10 500 g (!), second and third degree mesocardiac systolic beat and cardiomegaly in the thorax-cardiac-pulmonary X-ray examination. Despite the intensive treatment, death occurs few hours after hospitalization. During the autopsy, there is observed a partial dehiscence of the cranial arch sutures, with a 6/5 cm ovalary cavity in the parietal lobe, containing approximately 200 mL of yellow-green serous liquid, with uneven walls, but with no hemorrhagic or puss infiltrates. The heart is enlarged (in comparison to the general somatic development) of 9/7/4 cm, without any cardiac malformations. The microscopic examination showed degenerative neuronal and ischemic lesions on the left-brain hemisphere. Comparing to the data from specialty literature, we consider it as a yellow brain softening (according to Rokitansky's classification), most probably of an embolic cause.

Among the abnormal cord insertion pathology, velamentous cord insertion associated with rupture of vasa praevia is the most severe condition related to the outcome of the newborn. In velamentous cord insertion, the fetal vessels run freely through the fetal membranes without protection from Wharton's jelly, umbilical vessels diverging as they traverse the membranes. When the membranes are ruptured, complete tearing of fetal vessels through the torn membranes or partial rupture near the site of membrane rupture may occur. Velamentous insertion occurs in approximately 1% of singleton gestations, but is observed in as many as 15% of monochorionic twin gestations. The risk of perinatal death was doubled in pregnancies with velamentous cord insertion relative to normal cord insertion. This condition can be diagnosed by ultrasonography with a sensitivity of 67% and specificity of 100% in the second trimester. We report a case of a newborn who came from a velamentous cord insertion condition associated with rupture of vasa praevia after the spontaneously membranes rupture. After a difficult resuscitation and stabilization, the newborn survived with a good outcome after the follow-up.