Журнал детской неврологии и медицины

Etiological Factors and Evolution of Intracranial Hemorrhage in Term New-borns

Abstract

Lucas Hernández J*, Martínez Antón J and Urda Cardona A

Background: Intracranial hemorrhage is an uncommon but important cause of morbidity and mortality in term newborns of unknown incidence. Because of this, it is necessary to analyze and describe the etiological factors and symptomatology of presentation to the end of extending the knowledge that allows us to adapt the strategy and reduce diagnostic delay, as well as the development of possible neurological sequelae.

Methods: Retrospective study of term neonates diagnosed of intracranial hemorrhage in the first 28 days of life in a third level hospital between January 2008 and December 2015.

Results: Thirty one term newborns with intracranial hemorrhage were identified, with a mean age of diagnosis of 3.4 days of life. In 16/31 there was not obstetrical history of interest. Cesarean section was carried out in 13/31 and instrumental delivery in 6/31. The clinical manifestations included seizures in 10/31 and apnea in 7/31. In all cases, the first neuromaging test made was the brain ultrasound and at the time of diagnosis, 13/31 presented anemia and 3/31 thrombocytopenia. The most frequent type of intracranial hemorrhage was the intraparenchymal hemorrhage in 10/31 cases and bilateral hemispheric location was found in 14/31. In 14/31 the etiology was not identified and hypoxic-ischemic encephatologhy was the most common cause in 8/31. Only 1/31 case required urgent surgical intervention, 4/31 newborns died and up to the time of study, 5/31 have presented moderate-severe psychomotor delay and 3/31 partial symptomatic epilepsy.

Conclusion: In our series hypoxia and/or dystocia were the factors most frequently associated with the development of intracranial hemorrhage and seizures, apnea and anemia were the more common signs of presentation. Intraparenchymal hemorrhage was the most common variety and lower psychomotor delay was observed until the time of the study in relation to the literature.