Topics Discussed: cerebral hemisphere hemorrhage; germinal matrix hemorrhage; hematology; hematoma, subdural; hemorrhage, ventricular; intracranial hemorrhages; neurology; subarachnoid hemorrhage.
Excerpt:"An Intracranial hemorrhage (ICH) can occur in term and preterm infants. An ICH occurring in term infants tends to be subdural, subarachnoid, or subtentorial and is most related to birth trauma, hypoxic-ischemic events, coagulopathies (eg, thrombophilias or thrombocytopenia), and of an undetermined cause. An ICH in preterm infants is periventricular or intraventricular in location but originating from vascular rupture within the subependymal germinal matrix. Preterm infants may have periventricular hemorrhagic infarctions of white matter that follow germinal matrix-intraventricular hemorrhages.Definition. SDH involves tears of veins or venous sinuses traversing the subdural space. Vascular structures most affected are superficial cerebral veins, infratentorial posterior fossa venous sinuses, the inferior sagittal sinus, and tentorial sinuses and veins (eg, vein of Galen). Blood may accumulate and cause acute symptoms of intracranial pressure or reside as a hematoma that slowly evolves as a chronic subdural hematoma with increasing fluid accumulation and increasing intracranial pressure.
Incidence. SDH is uncommon in term and preterm infants. When it occurs, it usually follows a traumatic delivery of a late preterm or term infant. Among 111 asymptomatic term infants studied prospectively by MRI, 9 had SDH (8.0%), 3 after spontaneous vaginal deliveries and 6 after instrumented deliveries. None required treatment, and all were free of hematoma by 4 weeks of age. Moreover, all infants..."
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