Presentation
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]
Hematological
- Neonatal Hemorrhage
[…] had neonatal cerebral sinovenous thrombosis, 11 had hypoxic ischemic encephalopathy, and 5 had neonatal arterial ischemic stroke; and 5 patients with presumed perinatal hemorrhagic stroke. [neurologyadvisor.com]
Whereas neonatal hemorrhage is a relatively common occurrence, affecting 40% to 60% of infants delivered before 32 weeks of gestation, fetal intracranial hemorrhage is quite rare. [mhmedical.com]
Entire Body System
- Asymptomatic
In one of these children with a hemorrhagic spinal fluid and hypoglycorrhachia unaccompanied by clinical signs of intracranial hemorrhage or hydrocephalus, the axial tomography showed a significant although asymptomatic hydrocephalus. [ncbi.nlm.nih.gov]
CONCLUSION: SDH in asymptomatic term neonates after delivery is limited in size and location. [ajnr.org]
The clinical manifestations and clinical findings vary widely, ranging from asymptomatic to life-threatening bleeding, including intracranial hemorrhage (ICH), with prolonged prothrombin time, normal partial thromboplastin time and normal platelet counts [dovepress.com]
Mildly affected infants may be asymptomatic. [orpha.net]
But for this study, the researchers studied 88 asymptomatic newborns, evenly divided between male and female, of whom 65 were delivered vaginally and the remainder by caesarian. [medpagetoday.com]
- Hypothermia
Risk factors for intraventricular hemorrhage in term asphyxiated newborns treated with hypothermia. Pediatric neurology, 50(6), 630-635. Ballabh, P. (2010). Intraventricular hemorrhage in premature infants: mechanism of disease. [abclawcenters.com]
- Infertility
Other risk factors such as sex, mode of delivery, history of using infertility drugs, maternal disease, maternal hypertension and preeclampsia, lumbar puncture, ventilator therapy and pneumothorax were considered. [acta.tums.ac.ir]
Skin
- Ulcer
Treatment of spinal cord injury includes nursing care to prevent skin ulcerations, prompt treatment of urinary and respiratory infections, and regular evaluations to identify obstructive uropathy early. [merckmanuals.com]
Musculoskeletal
- Macrocephaly
Subdural hematoma generally presents as fetal macrocephaly, with separation of the skull from the cerebral cortex. Hyperechoic and hypoechoic ... [mhmedical.com]
Neurologic
- 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]
- 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]
- Nystagmus
Clinical findings included multiple ecchymoses, gastric hemorrhage, hematuria, a tense fontanelle, head circumference at the 95th percentile, hypotonia, and ocular bobbing and nystagmus. [pediatricneurologybriefs.com]
Treatment
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]
Prognosis
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]
Etiology
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]
Epidemiology
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]
Pathophysiology
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]
Prevention
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]