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Vitamin K deficiency bleeding presenting as impending brain herniation.

H Gopakumar¹, R Sivji, P K Rajiv

¹Department of Neonatology, Amrita Institute of Medical Sciences (AIMS), Kochi, Kerala, India.

Journal of Pediatric Neurosciences

|November 3, 2010

Summary

Vitamin K deficiency bleeding (VKDB) is rare due to routine newborn prophylaxis. This case highlights a rare late-onset intracranial hemorrhage from VKDB, emphasizing potential severe neurological complications.

Keywords:

Intracranial hemorrhage vitamin K deficiency bleeding

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Area of Science:

Pediatrics
Hematology
Neurology

Background:

Universal vitamin K prophylaxis at birth significantly reduces the incidence of vitamin K deficiency bleeding (VKDB).
Severe bleeding manifestations, once common, are now exceedingly rare in neonates receiving prophylactic vitamin K.
This practice aims to prevent hemorrhagic disease of the newborn.

Observation:

A case of late-onset vitamin K deficiency bleeding is presented.
The presentation involved intracranial hemorrhage with signs of impending coning (brain herniation).
This contrasts with the typical, less severe bleeding patterns usually observed.

Findings:

Severe VKDB can manifest with intracranial hemorrhage, a rare but serious complication.
The case involved multiple cranial sites of bleeding, suggesting extensive hemorrhagic diathesis.
Impending brain herniation is an exceptionally rare outcome of vitamin K deficiency bleeding.

Implications:

Clinicians should maintain a high index of suspicion for VKDB even in infants with delayed presentation.
Prompt diagnosis and management of VKDB are crucial to prevent severe neurological sequelae.
This case underscores the importance of recognizing atypical presentations of vitamin K deficiency.