Intracranial hemorrhages due to late-type vitamin K deficiency bleeding

Vitamin K deficiency bleeding (VKDB) represents a clinical picture characterized by bleedings due to insufficient levels of vitamin-K-dependent hemostatic factors. VKDB can be classified into three groups as early, classic, and late according to time of occurrence. Late-type VKDB has particular importance due to frequent intracranial hemorrhages that lead to high mortality and morbidity. In our study, we aimed to emphasize the importance of vitamin K prophylaxis in prevention of late-type VKDB.

Data of 12 infants treated for intracranial hemorrhage due to late-type VKDB in Baskent University Hospitals between June 1998 and June 2005 have been analyzed.

The ages of patients ranged between 25 and 90 days. Five were born in the hospital and seven were born at home. None of the infants born at home received vitamin K prophylaxis. Hemorrhages were classified as intraparenchymal in 58.33%, subarachnoid in 50.00%, subdural in 50.00%, intraventricular in 41.66%, and epidural in 8.33% according to cranial computerized tomography findings. Surgery was performed in seven cases (58.33%). A total of six patients died (50.00%). Three of the deaths were from the surgery-performed group.

All newborns should receive vitamin K prophylaxis to prevent bleeding due to vitamin K deficiency. Symptoms of any predisposing disease and warning bleeds must be noticed early and additional doses of vitamin K should be administered, if required.