| Spontaneous intraparenchymal hemorrhage in full-term neonates. | |
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MedLine Citation:
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PMID: 11334270 Owner: NLM Status: MEDLINE |
Abstract/OtherAbstract:
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OBJECTIVE: Spontaneous intraparenchymal hemorrhage is extremely rare in full-term newborns. Reports to date have been limited to descriptions of individual cases, small groups within larger studies of intracranial hemorrhage, and one series of four patients. Structural lesions are rarely identified, and the majority of patients described have been managed without surgical intervention. METHODS: Analysis of a computerized database of pediatric neurosurgical patients from January 1960 to February 2000 identified full-term newborns younger than 3 months of age with nontraumatic intraparenchymal hemorrhages. Prenatal histories, labor and delivery histories, clinical presentations, imaging studies, management, and outcomes were reviewed. RESULTS: Eleven full-term newborns with spontaneous intraparenchymal hemorrhages were identified. The majority had normal prenatal courses. Most presented within the first 2 days of life (6 of 11 patients), and the most common presenting sign was seizure (7 of 11 patients). No cause was identified in 6 of 11 patients; the remainder were attributed to coagulopathy (n = 3), ruptured intracranial aneurysm (n = 1), or hemorrhagic infarction (n = 1). Eight patients underwent surgical hematoma evacuation on the basis of radiographic evidence of significant mass effect, evidence of signs of elevated intracranial pressure, or both. Three patients did not receive surgical intervention. There were no subsequent hemorrhages or deaths during a mean follow-up period of 4.5 years (range, 1-16 yr). Four patients had normal neurological outcomes, four had motor deficits (one of whom additionally demonstrated cognitive delay), and three had delayed speech. CONCLUSION: No cause is identified in most newborns with spontaneous intraparenchymal hemorrhage. Radiographic evidence of mass effect or signs of elevated intracranial pressure may necessitate surgical hematoma evacuation. Outcome varies widely and may be normal, even in patients with sizeable intraparenchymal hemorrhages. |
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Authors:
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D I Sandberg; M Lamberti-Pasculli; J M Drake; R P Humphreys; J T Rutka |
Publication Detail:
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Type: Journal Article |
Journal Detail:
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Title: Neurosurgery Volume: 48 ISSN: 0148-396X ISO Abbreviation: Neurosurgery Publication Date: 2001 May |
Date Detail:
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Created Date: 2001-05-03 Completed Date: 2001-09-13 Revised Date: 2004-11-17 |
Medline Journal Info:
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Nlm Unique ID: 7802914 Medline TA: Neurosurgery Country: United States |
Other Details:
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Languages: eng Pagination: 1042-8; discussion 1048-9 Citation Subset: IM |
Affiliation:
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Division of Neurosurgery, The Hospital for Sick Children and the University of Toronto, Ontario, Canada. |
Export Citation:
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| MeSH Terms | |
Descriptor/Qualifier:
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Aneurysm, Ruptured
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complications Blood Coagulation Disorders / complications Cerebral Hemorrhage / complications, etiology, radiography, surgery* Cerebral Infarction / complications Cognition Disorders / etiology Female Hematoma / complications, etiology, surgery Humans Infant, Newborn Intracranial Aneurysm / complications Intracranial Pressure Language Development Disorders / etiology Male Movement Disorders / etiology Nervous System Diseases / etiology Postoperative Complications Seizures / etiology Tomography, X-Ray Computed |
From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine
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