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Symptomatic intracranial hemorrhage in full-term infants

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Abstract

A retrospective analysis was undertaken in a consecutive series of 33 full-term infants (birth weight >2500 g and a minimum of 37 weeks gestational age) with symptomatic intracranial hemorhage (ICH) admitted to a regional neonatal intensive care unit from January 1986 to December 1992. Eleven infants were born in our institution; 17 were male. The estimated local incidence of symptomatic ICH for the inborn population was 4.9/10 000 live births, with a regional incidence of 2.7/10 000 live births. Twenty-four (72.3%) infants presented with seizures, apnea, or respiratory distress. Five (15.1%) children developed ICH associated with extracorporeal membrane oxygenation, ventriculoperitoneal shunting, and cardiac surgery. There were two deaths (6.1%) associated with a grade IV periventricular hemorrhage (PVH) and cardiac surgery. Nine infants (27.3%) showed PVH, while an additional nine children developed multifocal cortical hemorrhages. Eight infants (24.%) showed extraxial ICH, four children (12.1%) sustained lobar hemorrhages, and three children (9.1%) showed ICH associated with prenatal CNS abnormalities. Excluding five children with iatrogenic ICH, coagulopathies occurred in 9 of 28 infants (32.1%) and constituted a major determinant of the development of ICH. Neurosurgical intervention was limited to one infant with massive ICH and one child with hydrocephalus as a late sequela of ICH. Developmental follow-up was complete in 32 children with a mean and median duration of 3.4 years. Full-term infants with ICH associated with risk factors for hypoxic-ischemic injury showed a significantly greater risk of developmental delay compared to infants with uncomplicated ICH.

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Authors and Affiliations

  1. Department of Neurosurgery, University of Illinois College of Medicine at Peoria, P.O. Box 1649, 61656, Peoria, IL, USA

    William C. Hanigan

  2. Department of Radiology, University of Texas Medical School at Houston, 6431 Fannin, 77225, Houston, TX, USA

    Frank C. Powell

  3. Department of Pediatrics, University of Illinois College of Medicine at Peoria, P.O. Box 1649, 61656, Peoria, IL, USA

    Tim C. Miller

  4. Department of Radiology, University of Illinois College of Medicine at Peoria, P.O. Box 1649, 61656, Peoria, IL, USA

    Robert M. Wright

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  1. William C. Hanigan
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Hanigan, W.C., Powell, F.C., Miller, T.C. et al. Symptomatic intracranial hemorrhage in full-term infants. Child's Nerv Syst 11, 698–707 (1995). https://doi.org/10.1007/BF00262235

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