In the present study, the most frequent form of ICH in neonates was SDH. Focal seizures, disturbed consciousness level, tense anterior fontanel, unexplained anemia, and respiratory distress were the major presenting signs. [ncbi.nlm.nih.gov]

In relation to the symptoms of presentation, 10/31 presented seizures, 7/31 apnea and 2/31 multiorgan failure, requiring mechanical ventilation connection 13/31 patients. [omicsonline.org]

All women presenting with postpartum hemorrhage should have a bleeding work-up to determine whether an inherited bleeding disorder such as hemophilia or von Willebrand disease is present. [hemophilia.org]

Germinal matrix hemorrhage can only occur when the germinal matrix is present and is therefore only seen in premature infants. [radiopaedia.org]

• Cerebral Palsy

  More severe bleeds can result in mental and physical impairments such as developmental delays, learning disabilities, and cerebral palsy (CP). [abclawcenters.com]

  Intraventricular hemorrhage is a significant risk factor for Cerebral Palsy. It is most common in premature babies, especially those who have experienced respiratory distress syndrome, collapsed lung, or high blood pressure. [cerebralpalsy.org]

  Kruse M, Michelsen SI, Flachs EM, Brønnum-Hansen H, Madsen M, Uldall P: Lifetime costs of cerebral palsy. Dev Med Child Neurol 2009; 51: 622–8. CrossRef MEDLINE [aerzteblatt.de]

• Sepsis

  Thus, factors that predispose to ischemia, such as placental insufficiency and sepsis, increase the risk of ICH. [ahcmedia.com]

  In the current study, none of our patients had sepsis, and consequently, sepsis was not a factor for this study. In our study, the incidence of ICH (34%) is relatively higher compared with ELSO registry data (11%) [ 8 ]. [jintensivecare.biomedcentral.com]

  6 months) (Medical Encyclopedia) Failure to thrive (Medical Encyclopedia) Hemorrhagic disease of the newborn (Medical Encyclopedia) Hyperglycemia - infants (Medical Encyclopedia) Neonatal respiratory distress syndrome (Medical Encyclopedia) Neonatal sepsis [icdlist.com]

  Delayed cord clamping in very preterm infants reduces the incidence of intraventricular hemorrhage and late-onset sepsis: a randomized, controlled trial. Pediatrics. 2006;117:1235. PubMed CrossRef Google Scholar 23. [link.springer.com]

  Mercer JS, Vohr BR, McGrath MM, Padbury JF, Wallach M, Oh W: Delayed cord clamping in very preterm infants reduces the incidence of intraventricular hemorrhage and late-onset sepsis: a randomized, controlled trial. Pediatrics 2006; 117: 1235–42. [aerzteblatt.de]

• Collapse

  It is most common in premature babies, especially those who have experienced respiratory distress syndrome, collapsed lung, or high blood pressure. [cerebralpalsy.org]

  Most intraventricular hemorrhages are asymptomatic, but larger hemorrhages may cause apnea, cyanosis, or sudden collapse. Prognosis for infants with small intraventricular hemorrhages is good. [merckmanuals.com]

  In the placebo group, one woman had sepsis, one had respiratory distress, one had uterine hemorrhage, and one had cardiopulmonary collapse. None of these events were considered to be related to the study drug. [nejm.org]

  […] is sequential remodeling and considerable individual variation in the pattern and size of different veins entering the internal cerebral veins, (iii) immature veins have high caliber and thin wall, they branch parallel to the ventricle, hence tend to collapse [intechopen.com]

  Sagittal image (C) showing a dilated third ventricle and completely collapsed fourth ventricle. [ijri.org]

• Hypoxemia

  […] many risk factors for the development of intracranial hemorrhage in preterm infants, such as low gestational age (LGA) and birth weight, maternal chorioamnionitis and other infections or inflammation, lack of antenatal steroid exposure, hypotension, hypoxemia [emedicine.medscape.com]

  As a result, the normal drop in pulmonary vascular resistance (PVR) fails to take place after birth leading to hypoxemia [ 4 ]. [jintensivecare.biomedcentral.com]

  Chronic hypoxemia or hypoperfusion leads to PVL. [ijri.org]

• Respiratory Distress

  The most common general manifestations included pallor, respiratory distress, and bleeding from other sites. [ncbi.nlm.nih.gov]

  In Group A (n = 232), respiratory distress syndrome, ventilator therapy, PaCO 2 ≥ 60 mmHg, Po 2 ≤ 40 mmHg ≥ 2 h, lower 1- and 5-min Apgar scores, lower pediatric estimation of gestational age, and pneumothorax were significantly associated with PVH-IVH [utsouthwestern.influuent.utsystem.edu]

  Surfactant therapy for respiratory distress syndrome in newborns of 600-750 g birth weight caused an increased risk of grades I and II intracranial hemorrhage compared to controls, in analyses of the literature by researchers at Ross Laboratories, Columbus [pediatricneurologybriefs.com]

  It is most common in premature babies, especially those who have experienced respiratory distress syndrome, collapsed lung, or high blood pressure. [cerebralpalsy.org]

  distress syndrome, and many others. [4, 5, 6] In all cases, however, GMH results from a combination of the intrinsic fragility of the germinal matrix vasculature, disturbances in cerebral blood flow, and coagulation disorders. [emedicine.medscape.com]

• Hypotension

  Dempsey EM, Barrington KJ: Treating hypotension in the preterm infant: when and with what: a critical and systematic review. J Perinatol 2007; 27: 469–78. 28. [aerzteblatt.de]

  […] have identified many risk factors for the development of intracranial hemorrhage in preterm infants, such as low gestational age (LGA) and birth weight, maternal chorioamnionitis and other infections or inflammation, lack of antenatal steroid exposure, hypotension [emedicine.medscape.com]

  The admission diagnoses at the receiving hospital were: 1) 34-35 weeks gestation, AGA, female infant; 2) respiratory failure; 3) septic shock; 4) hypotension secondary to septic shock; and 5) DIC secondary to septic shock. [ispub.com]

  Among the infants delivered before 34 weeks' gestation, the phenobarbital and placebo groups were similar with respect to the frequency of respiratory failure (defined as the need for ventilatory support), acidosis (arterial-blood pH, 65 mm Hg), and hypotension [nejm.org]

  […] autoregulation mechanism maintains a relatively constant cerebral blood flow (CBF) across a range of cerebral perfusion pressures.[ 4 ] Various extrinsic hemodynamic factors that potentially interfere with the integrity of the vulnerable GM include low CBF (hypotensive [intechopen.com]

• Abnormal Eye Movement

  Most common signs of intracranial hemorrhage include: Apnea (breathing pauses) Pale or blue coloring Abnormal eye movement Shrill cry Seizures Decreased muscle tone Decreased reflexes Excessive sleep Lethargy Weak suck Fallen blood count It is recommended [cerebralpalsy.org]

  eye movement or alignment, abnormal pupillary response, and abnormal neuromotor examination (hypotonia, decresased motility, tight popliteal angle). [ 1, 3 ] The pattern of hemorrhage also differs from GM hemorrhage common in preterm newborns in having [intechopen.com]

• Meningism

  Abstract Cerebrospinal fluid (CSF) lactate dehydrogenase (LDH) was measured in 54 neonates with intracranial hemorrhage and compared with 82 control, 27 traumatic lumbar puncture, seven meningitis, and 30 asphyxiated newborns. [ncbi.nlm.nih.gov]

  Term infants Epidural hemorrhage is relatively rare in newborns, because the middle meningeal artery, the tearing of which is the usual cause of epidural hemorrhage, moves freely away from displacements of the skull in this age group. [emedicine.medscape.com]

  Note the gross widening of CSF spaces indicating loss of volume Click here to view Figure 37 (A, B): Large occipital meningocele with multiple layers of meninges and cystic cerebral parenchyma shown on USG (A). [ijri.org]

  The lumbar puncture must be done with meticulous technique because meningitis is a potential risk. In addition, electrolytes should be measured periodically if large volumes of fluid are removed. [uichildrens.org]

• Lethargy

  […] tingling, weakness, numbness, paralysis, severe headache, difficulty with swallowing or vision, loss of balance or coordination, difficulty understanding, speaking, reading, or writing, and a change in level of consciousness or alertness, marked by stupor, lethargy [my.clevelandclinic.org]

  Clinical signs of subdural hematoma in infants include irritability, lethargy, vomiting and bulging soft spot. [cerebralpalsy.org]

  The most common symptoms seen in premature infants include: Breathing pauses (apnea) Changes in blood pressure and heart rate Decreased muscle tone Decreased reflexes Excessive sleep Lethargy Weak suck Seizures and other abnormal movements All babies [medlineplus.gov]

  Intracranial hemorrhage is suspected in neonates with Apnea Seizures Lethargy Abnormal neurologic examination Such infants should have a cranial imaging study as part of the initial evaluation. [merckmanuals.com]

• Communicating Hydrocephalus

  Ventricular enlargement usually resolves, but may persist as obstructive post hemorrhagic hydrocephalus, communicating hydrocephalus secondary to arachnoiditis or due to inflammatory ependymitis. [sonoworld.com]

  […] may generate an inflammatory response that damages the arachnoid granulations, inhibiting the regular reabsorption of CSF and resulting in permanent communicating hydrocephalus. [2] [10] Babies [ edit ] IVH in the preterm brain usually arises from the [en.wikipedia.org]

  The mechanisms by which hydrocephalus develop include: Communicating hydrocephalus : decreased absorption of cerebral spinal fluid (CSF) secondary to obstruction of arachnoid villi by blood and debris or the development of arachnoiditis Obstructive hydrocephalus [radiologyassistant.nl]

  However, with large hemorrhages, the associated meningeal inflammation may lead to a communicating hydrocephalus as the infant grows. Treatment of subarachnoid hemorrhage is supportive with appropriate monitoring to detect hydrocephalus. [merckmanuals.com]

• Neonatal Seizures

  Neurologic manifestations like neonatal seizure, decreased level of consciousness, increased intracranial pressure are the most common presentations of ICH in term newborns. [intechopen.com]

• Motor Disturbances

  A major motor disturbance occurred in 16% of patients; their Ct scans showed evidence of brain destruction involving enlargement of a lateral ventricle, porencephaly, or focal atrophy. [ncbi.nlm.nih.gov]

Sidiropoulos D, Straume B: The treatment of neonatal isoimmune thrombocytopenia with intravenous immunoglobin (IgG iv). Blut 1984;48:383-386. [karger.com]

NHF under no circumstances recommends particular treatment for specific individuals, and in all cases recommends that you consult your physician or local treatment center before pursuing any course of treatment. [hemophilia.org]

Focused on treatment: key points boxes pick out the most important information for the busy specialist. Evidence-based information: extensively referenced with the latest and most important papers and articles. [books.google.com]

Maternal bacterial infection and bed rest may trigger deep-vein femoral thrombosis in women with a homozygous Leiden mutation on tocolytic therapy for the treatment of premature labor. [ncbi.nlm.nih.gov]

Neurodevelopmental outcome was evaluated at 18-22 months corrected age by certified examiners masked to treatment status. [clinicaltrials.gov]

Treatment and prognosis The ideal treatment is the prevention of premature delivery. [radiopaedia.org]

The prognosis for subdural hemorrhage is guarded, but some neonates do well. [merckmanuals.com]

Cerebellar hemorrhage is rare, associated with poor prognosis and is seen as an echogenic area within the cerebellum with non-visualization of the 4th ventricle. [sonoworld.com]

Grading of severity uses a similar scale to that for neonatal intraventricular hemorrhage (IVH), with prognosis being quite poor for most cases of Grades III or IV IVH. [mhmedical.com]

Intraventricular hemorrhage and brain injury in the premature infant: diagnosis, prognosis and prevention. Clinics in perinatology 1989;16(2):387-411. [uichildrens.org]

The possible etiologic roles of infection and bed rest are discussed in connection with a case of maternal homozygous Leiden mutation leading to prematurity, maternal deep-vein thrombosis and neonatal intracranial hemorrhage in a heterozygous premature [ncbi.nlm.nih.gov]

3: Etiology of ICH in term new-borns. [omicsonline.org]

Maternal salicylate ingestion should be considered in the etiology of neonatal intracranial hemorrhage without birth trauma. The infant’s relatively low salicylate level is not inconsistent with chronic toxicity. [pediatricneurologybriefs.com]

In many cases, the etiology of the hemorrhage is unknown. [2] [emedicine.medscape.com]

Summary Epidemiology The incidence has been estimated at 1/800 to 1/1 000 live births. Clinical description NAIT has been considered to be the platelet counterpart of Rh Haemolytic Disease of the Newborn (RHD). [orpha.net]

Standardizing the structure of stroke clinical and epidemiologic research data: the National Institute of Neurological Disorders and Stroke (NINDS) Stroke Common Data Element (CDE) project. Stroke. 2012;43(4):967-973. [neurologyadvisor.com]

The aim of this study is to analyze the etiological factors, evolution and neurological prognosis of term new-borns affected by intracranial hemorrhage and epidemiological data associated with our series, in order to understand better the clinical characteristics [omicsonline.org]

"Traumatic Brain Injury: Definition, Epidemiology, Pathophysiology" Emedicine.com. Retrieved on June 19, 2007. ^ Vinas FC and Pilitsis J. 2006. "Penetrating Head Trauma." [en.wikipedia.org]

The pathophysiology of ICH is complex. Some cases of ICH may be attributable to the hyperperfusion that follows a period of ischemia in the immature brain during which cerebral flow autoregulation is not fully developed. [ahcmedia.com]

“Collectively, evidence suggests NHS pathophysiology involves rare events occurring in uniquely susceptible individuals rather than any controllable external factors, limiting opportunities for prevention,” the researchers concluded. [neurologyadvisor.com]

Lesions which occur in the periventricular white matter occur in 3-10% of infants with birth weight Pathophysiology As the name implies, PVH originate in the tissue abutting the lateral ventricle, e.g., germinal matrix. [uichildrens.org]

"Traumatic Brain Injury: Definition, Epidemiology, Pathophysiology" Emedicine.com. Retrieved on June 19, 2007. ^ Vinas FC and Pilitsis J. 2006. "Penetrating Head Trauma." [en.wikipedia.org]

Access personal reporting Related Content This Book Next chapter Gender Differences in Incidence, Pathophysiology, and Outcome of Primary Intracerebral Hemorrhage By Michael James and Sankalp Gokhale Related Book First chapter Automatic Vector Seeded [intechopen.com]

Abstract Knowledge of the timing and course of neonatal intracranial hemorrhage is essential in determining the etiology of hemorrhage, since the key to preventing neurologic damage in newborns is to define preventable causes and to treat the complications [ncbi.nlm.nih.gov]

For these reasons, antenatal therapy should be a more effective preventive strategy than postnatal therapy. [nejm.org]

Preventing preterm delivery is the best way to prevent IVH, so expectant mothers with risks for preterm delivery should talk to their doctors about lowering their risk. Several medications have been studied for their role in preventing IVH. [verywell.com]

The ability to predict the occurrence of neonatal periventricular-intraventricular hemorrhage (PVH-IVH) would be useful in the design of clinical trials to prevent its occurrence. [utsouthwestern.influuent.utsystem.edu]