Intracranial hemorrhage in neonates: A review of etiologies, patterns and predicted clinical outcomes. (July 2018)

• Record Type: Journal Article
• Authors: Tan, Ai Peng; Svrckova, Patricia; Cowan, Frances; Chong, Wui Khean; Mankad, Kshitij
• Is Part Of: European journal of paediatric neurology. Volume 22:Number 4(2018:Jul.)
• Page Start: 690
• Page End: 717
• Publication Date: 2018-07
• Subjects: Neonatal intracranial hemorrhage -- Type IV collagen genes -- Cerebral venous sinus thrombosis (CVST) -- Intraventricular hemorrhage (IVH) -- Germinal matrix hemorrhage (GMH) -- Congenital brain tumors (CBTs); Pediatric neurology -- Periodicals; Nervous System Diseases -- Periodicals; Child -- Periodicals; Infant -- Periodicals; Neurologie pédiatrique -- Périodiques; Pediatric neurology; Electronic journals; Periodicals; Electronic journals; 618.928
• DOI: 10.1016/j.ejpn.2018.04.008
• Languages: English
• ISSNs: 1090-3798

Abstract

Abstract: Intracranial hemorrhage (ICH) in neonates often results in devastating neurodevelopmental outcomes as the neonatal period is a critical window for brain development. The neurodevelopmental outcomes in neonates with ICH are determined by the maturity of the brain, the location and extent of the hemorrhage, the specific underlying etiology and the presence of other concomitant disorders. Neonatal ICH may result from various inherited and acquired disorders. We classify the etiologies of neonatal ICH into eight main categories: (1) Hemorrhagic stroke including large focal hematoma, (2) Prematurity-related hemorrhage, (3) Bleeding diathesis, (4) Genetic causes, (5) Infection, (6) Trauma-related hemorrhage, (7) Tumor-related hemorrhage and (8) Vascular malformations. Illustrative cases showing various imaging patterns that can be helpful to predict clinical outcomes will be highlighted. Potential mimics of ICH in the neonatal period are also reviewed. Highlights: SDH and parenchymal hemorrhage is more common in term; SAH, IVH and CH in preterm. If there is IVH or unilateral thalamic hemorrhage in a term neonate, suspect CVST. Asymptomatic SDH unrelated to a difficult delivery is common and with good outcome. Interhemispheric SAH or hemorrhages of varying ages should raise suspicion for NAI. DSM, VGAM and intracranial hemangioma are important mimics of ICH.