Diagnostic clues in spontaneous intracranial hemorrhage in babies

Abstract

Background There has been increasing number of babies detected
with SIH. In regard to find diagnostic clues for the first-rate babies
who really needs CT scan and referral, simple observation to look
at certain clinical and laboratory findings is needed.
Objective To identify diagnostic clues associated with spontaneous
intracranial hemorrhage (SIH) in babies.
Methods Retrospective observation was carried out among ba-
bies with SIH within the last two and a half years. Patients were
excluded if there was an obvious cause of SIH such as trauma or
any underlying disease such as hemophilia. Variables that were
observed were patient's age, seizure, decreased level of conscious-
ness, tensed fontanel, neurological deficits, vomitting, fever
(T > 3 7 .SOC), anemia, jaundice, PT and aPTT. All data were
descriptively evaluated.
Results There were 53 babies with SIH (31 baby boys, 22 baby
girls), forty eight of which (91%) were less than 3 months old.
Of those, 50 patients (94%) had seizure as the leading clinical
presentation, 44 patients (83%) had decreased level of conscious-
ness, and 39 patients (74%) had tensed fontanel. PT and aPTT
were prolonged in 39 (74%) cases. The most common lesion was
subdural hematoma (38 cases/72%). Forty-three babies (81 o/o)
required neurosurgical intervention. Overall mortality rate was
22%.
Conclusion Babies with seizure, decreased level of consciousness,
tensed fontanel, and prolonged PT and aPTT should be considered
to harbor SIH. They need a CT scan and referral, particularly
those less than three months old. The prognosis is unfavorable,
thus early recognition and treatment is needed