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Intracranial hemorrhage due to vitamin K deficiency in infants: a clinical study
1Department of Pediatric Neurology, Faculty of Medicine, Mustafa Kemal University, Hatay, Turkey. drcahideyilmaz@hotmail.com
Insights
Late-onset vitamin K deficiency causes intracranial hemorrhage (ICH) in infants, leading to significant mortality. Prompt vitamin K administration can correct clotting abnormalities and prevent severe outcomes.
Area of Science:
- Pediatrics
- Neurology
- Hematology
Background:
- Late-onset vitamin K deficiency is a preventable cause of intracranial hemorrhage (ICH) in infants.
- ICH in infants presents with diverse neurological and physical signs, including convulsions and fontanel changes.
Purpose of the Study:
- To evaluate the clinical characteristics, management, and outcomes of infants diagnosed with intracranial hemorrhage due to vitamin K deficiency.
- To highlight the persistent public health challenge posed by vitamin K deficiency-related ICH in Turkey.
Main Methods:
- Retrospective evaluation of hospital records for 30 infants diagnosed with ICH from vitamin K deficiency between 2001 and 2005.
- Analysis of clinical signs, physical examination findings, laboratory results (prothrombin time, activated partial thromboplastin time), and treatment interventions.
Main Results:
- Common symptoms included convulsions (80%), poor sucking (50%), and irritability (40%).
- Physical findings revealed bulging fontanel (63%) and diminished neonatal reflexes (37%).
- All infants had prolonged PT, corrected by vitamin K; intraparenchymal hemorrhage was the most common ICH type (33% mortality).
Conclusions:
- Intracranial hemorrhage due to vitamin K deficiency remains a significant health issue in infants.
- High mortality rates underscore the importance of vitamin K prophylaxis and timely diagnosis.
Abstract:
The hospital records of 30 infants with a diagnosis of intracranial hemorrhage (ICH) due to late onset of vitamin K deficiency, seen during a 5-year period (2001-2005) were retrospectively evaluated. Signs and symptoms of the patients were convulsions (80%), poor sucking (50%), irritability (40%), vomiting (47%), acute diarrhea (33%), and fever (40%). On physical examination there were bulging or full fontanel in 19 patients (63%), collapsed fontanel in one (3%), diminished or absent neonatal reflexes in 11 (37%), pallor in 14 (47%), and cyanosis in one (3%) patient. Gastrointestinal disorder, skin hemorrhagic findings, and epistaxis each were noted in two (7%) patients. All the infants had prolonged prothrombin time (PT) and seven had prolonged activated partial thromboplastin time (APTT), both of which were corrected by the administration of vitamin K. All the infants had ICH, with the most common being intraparenchymal hemorrhage, followed by multiple type ICH (27%). Neurosurgical intervention was performed in five patients (17%). The overall case fatality rate was 33%. In conclusion, we would like to stress that ICH due to vitamin K deficiency in infants is still an important health problem in Turkey resulting in high mortality rate.
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