Intracranial hemorrhage in full-term newborns: a hospital-based cohort study

• DOI: 10.1007/s00234-010-0698-1
• Publication Date: 2010-04-14T07:45:46Z
• Authors: Annemieke J. Brouwer; Floris Groenendaal; Corine Koopman; Rutger-Jan A. Nie...; Sen K. Han; Linda S. de Vries
• Keywords: Perinatal asphyxia; Subdural hemorrhage; Neuroradiology

In recent years, intracranial hemorrhage (ICH) with parenchymal involvement has been diagnosed more often in full-term neonates due to improved neuroimaging techniques. The aim of this study is describe clinical and data the neonatal period relate imaging findings outcome a hospital-based population admitted level 3 intensive care unit (NICU).From our database, we retrospectively retrieved records images 53 term infants (1991-2008) whom an diagnosis ICH was made. Clinical data, including mode delivery, manifestations, neurological symptoms, extent site hemorrhage, neurosurgical intervention, neurodevelopmental outcomes, were recorded.Seventeen had infratentorial ICH, 20 supratentorial 16 combination two. Seizures most common presenting symptom (71.7%), another ten (18.9%) presented apneic seizures, five no signs but NICU because perinatal asphyxia (n=2), respiratory distress development posthemorrhagic ventricular dilatation (n=1). Continuous amplitude-integrated electroencephalography recordings performed all infants. or subclinical seizures seen 48/53 (90.6%) infants; received anti-epileptic drugs. Thirteen (24.5%) died. lowest mortality rate (10%). Three midline shift required craniotomy, six needed subcutaneous reservoir outflow obstruction, three subsequently ventriculoperitoneal shunt. group poor (death developmental quotient (DQ) <85) significantly lower 5-min Apgar score (p=.006). Follow-up available for 37/40 survivors aged at least 15 months. Patients assessed Griffiths Mental Developmental Scales, mean DQ 97 (SD=12). Six (17%) below 85 [two them cerebral palsy (CP)]. developed CP (8.6%); one cerebellar ataxia, two hemiplegia.ICH carries risk adverse sequelae 24.5% 8.6%. high could partly be explained by associated asphyxia. Infants lower, although not significant, compared ICH. spite large intraparenchymal lesions, 30 34 without (88.2%) normal