Document Detail


Spontaneous intracranial hemorrhage in children.
MedLine Citation:
PMID:  19221461     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
AIM: Spontaneous intracranial hemorrhage (SICH) in children is relatively less common as compared to adults, and there are limited studies addressing this issue in children. In this study, we analyze the etiology, clinical features, treatment options and outcome assessment in this population. MATERIAL AND METHODS: Fifty consecutive patients of spontaneous intracerebral bleed, aged 18 years and below, were retrospectively analyzed based on medical records and radiographic images. Status of the patient at the final follow-up after discharge was considered as the outcome. RESULTS: Age of patients ranged from 2 months to 17 years with higher predilection in males (M:F = 3:2). Presenting features were symptoms of raised intracranial pressure (70.0%), deterioration in sensorium (50.0%), limb weakness (36.0%) and seizures (28%). Arteriovenous malformation (AVM) was the most common cause of hemorrhage, and was found in 22 patients (44%), followed by cerebral aneurysm in 17 cases (34%), moyamoya disease in 3 cases (6%), and intracranial tumor, hematological disorders and unknown cause (possible vasculitis) were each found in 2 patients (4%). Treatment modalities consisted of: excision of AVM, aneurysm clipping, embolization, superficial temporal artery to middle cerebral artery bypass, tumor excision, hematoma evacuation and conservative management. Thirty-five patients (74%) had good outcome and 13 patients had poor outcome (26%). CONCLUSIONS: Aneurysm is an important cause of SICH, alongside AVM, which is the leading cause. Thorough investigation is necessary to elucidate the cause of bleed, which may otherwise be missed. Cerebellar bleed and late presentation were found to be associated with poor outcome. Age was not found to be associated with outcome.
Authors:
Raj Kumar; Dinesh Shukla; A K Mahapatra
Publication Detail:
Type:  Journal Article     Date:  2009-02-17
Journal Detail:
Title:  Pediatric neurosurgery     Volume:  45     ISSN:  1423-0305     ISO Abbreviation:  Pediatr Neurosurg     Publication Date:  2009  
Date Detail:
Created Date:  2009-03-19     Completed Date:  2009-05-18     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  9114967     Medline TA:  Pediatr Neurosurg     Country:  Switzerland    
Other Details:
Languages:  eng     Pagination:  37-45     Citation Subset:  IM    
Affiliation:
Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, India. rajkumar@sgpgi.ac.in
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Age of Onset
Child
Child, Preschool
Female
Follow-Up Studies
Humans
Infant
Intracranial Aneurysm / complications*,  radiography,  surgery
Intracranial Arteriovenous Malformations / complications*,  radiography,  surgery
Intracranial Hemorrhages / etiology*,  radiography,  surgery
Male
Moyamoya Disease / complications*,  radiography,  surgery
Neurosurgical Procedures
Retrospective Studies
Tomography, X-Ray Computed

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