Intracranial hemorrhage in term neonates

Area of Science:

• Neonatal Neurology
• Pediatric Radiology
• Neurocritical Care

Background:

• Intracranial hemorrhage (ICH) is a critical cause of morbidity and mortality in term neonates.
• Improved neuroimaging techniques have led to increased diagnosis of neonatal ICH.

Purpose of the Study:

• To evaluate the clinical characteristics of neonatal ICH.
• To analyze neuroimaging data, including pattern, size, and distribution of ICH in neonates.

Main Methods:

• Retrospective review of MRI data from 42 term neonates with ICH (less than 1 month old).
• Data collected included clinical manifestations, delivery mode, Apgar scores, hypoxic insult, birth trauma, neurological symptoms, EEG, hemorrhage extent/site, interventions, and outcomes.
• Risk factors for ICH and their association with clinical outcomes were assessed.

Main Results:

• Seizures (40.5%) and apnea (16.7%) were the most common presenting symptoms.
• Subdural hemorrhage (SDH) was the most frequent type (95.2%), often along the tentorium and cerebellar hemispheres.
• Perinatal asphyxia (50.0%) and traumatic delivery (47.6%) were common. Poor outcomes were associated with low Apgar scores and perinatal asphyxia.

Conclusions:

• SDH is the predominant type of ICH in term infants.
• Combined supratentorial and infratentorial hemorrhages were more frequent than isolated infratentorial types.
• Perinatal asphyxia was the most significant risk factor for poor clinical outcomes in neonates with ICH.