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Intracranial Hemorrhage in Term and Late-Preterm Neonates: An Institutional Perspective.
A G Sandoval Karamian1, Q-Z Yang2, L T Tam3
1From the Division of Child Neurology (A.G.S.K.), University of Utah, Salt Lake City, Utah.
AJNR. American Journal of Neuroradiology
|September 22, 2022
Summary
Intracranial hemorrhage is uncommon in term and late-preterm infants but presents in various locations, with intraventricular and subdural types being most frequent. Venous congestion or thromboses frequently accompany these neonatal hemorrhages.
Area of Science:
- Neonatal neurology
- Pediatric radiology
- Neuroimaging
Background:
- Intracranial hemorrhage distribution in term and late-preterm neonates is not well-understood.
- This study investigates the spectrum of intracranial hemorrhage detectable by MRI in this population.
Purpose of the Study:
- To describe the prevalence and distribution of intracranial hemorrhage in term and late-preterm neonates.
- To identify potential clinical risk factors associated with neonatal intracranial hemorrhage.
Main Methods:
- Retrospective analysis of brain MR imaging in 725 term/late-preterm neonates (January 2011-August 2018).
- Assessment of hemorrhage distribution (intraventricular, subarachnoid, subdural, intraparenchymal, subpial/leptomeningeal).
- Review of clinical data for risk factors including delivery method and coagulopathy markers.
Main Results:
- Intracranial hemorrhage occurred in 9% (63/725) of neonates, with 83% having multicompartment involvement.
- Most common locations were intraventricular (65%) and subdural (62%).
- High prevalence of venous congestion/thromboses (54% cortical vein, 59% periventricular/medullary vein, 8% cerebral venous sinus) and coagulopathy markers (59%) were observed.
Conclusions:
- Intracranial hemorrhage, though infrequent, shows diverse distribution in term/late-preterm infants, with intraventricular and subdural types predominating.
- A significant association between neonatal intracranial hemorrhage and venous congestion or thromboses is reported.
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