Pediatrics & Neonatology
Volume 51, Issue 4 , Pages 208-213, August 2010

Clinical Manifestations of Symptomatic Intracranial Hemorrhage in Term Neonates: 18 Years of Experience in a Medical Center

  • Mei-Chen Ou-Yang

      Affiliations

    • Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chiayi, Taiwan
    • Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
    • Chang Gung University College of Medicine, Kaohsiung, Taiwan
    • ,
  • Chung-Bin Huang

      Affiliations

    • Department of Pediatrics, Kuang Tien General Hospital, Taichung, Taiwan
    • Department of Nursing, Hung Kuang University, Taichung, Taiwan
    • ,
  • Hsin-Chun Huang

      Affiliations

    • Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
    • Chang Gung University College of Medicine, Kaohsiung, Taiwan
    • ,
  • Mei-Yung Chung

      Affiliations

    • Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
    • Chang Gung University College of Medicine, Kaohsiung, Taiwan
    • ,
  • Chih-Cheng Chen

      Affiliations

    • Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
    • Chang Gung University College of Medicine, Kaohsiung, Taiwan
    • ,
  • Feng-Shun Chen

      Affiliations

    • Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
    • Chang Gung University College of Medicine, Kaohsiung, Taiwan
    • ,
  • Pei-Hsin Chao

      Affiliations

    • Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
    • Chang Gung University College of Medicine, Kaohsiung, Taiwan
    • ,
  • I-Lun Chen

      Affiliations

    • Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
    • Chang Gung University College of Medicine, Kaohsiung, Taiwan
    • ,
  • Mei-Hui Ou-Yang

      Affiliations

    • San An Hospital, Kaohsiung, Taiwan
    • ,
  • Chieh-An Liu

      Affiliations

    • Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan
    • Chang Gung University College of Medicine, Kaohsiung, Taiwan
    • Corresponding Author InformationCorresponding author. Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital at Kaohsiung, 123 Ta-Pei Road, Niao-Sung Hsiang, Kaohsiung Hsien 833, Taiwan

Received 26 May 2009; received in revised form 22 September 2009; accepted 5 October 2009.

Article Outline

Background

Intracranial hemorrhage (ICH) is an uncommon but important cause of morbidity and mortality in term neonates. We conducted a retrospective analysis of the clinical characteristics and developmental outcomes of symptomatic ICH in term neonates.

Methods

A retrospective chart review was conducted of all term neonates (less than 1 month old) diagnosed with ICH and admitted to the neonatal intensive care unit of Kaohsiung Chang Gung Hospital from December 1991 to December 2008. Demographic characteristics, mode of delivery, laboratory data, clinical presentation, and developmental status were recorded.

Results

Data for 24 term neonates (17 boys and 7 girls) with a diagnosis of ICH were collected for analysis. The clinical manifestations of ICH included anemia (13/24, 54%), seizure (11/24, 46%), cyanosis (7/24, 29%), tachypnea (5/24, 21%), fever (1/24, 4%), hypothermia (1/24, 4%), and poor feeding (1/24, 4%). Age at symptom onset ranged from 2 hours to 11 days following birth. The most common type of ICH was subdural hemorrhage. All ICHs resolved, except in one infant, who died from hypoxicischemic encephalopathy at 25 days. Ten children with symptomatic ICH were reported to have normal development, while the remainder (13/23, 57%) showed developmental delays or disabilities.

Conclusion

Unexplained anemia, seizure, and cyanosis were the major presenting signs in infants with symptomatic ICH. A diagnosis of ICH should be considered in term neonates who present with one or more of these signs. Although the mortality in term infants with symptomatic ICH was low, more than half

Key Words:  intracranial hemorrhage , outcomes , term neonates

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PII: S1875-9572(10)60040-X

doi:10.1016/S1875-9572(10)60040-X

Pediatrics & Neonatology
Volume 51, Issue 4 , Pages 208-213, August 2010

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