Intracranial hemorrhage due to late-onset vitamin K deficiency bleeding

Vitamin K prophylaxis at birth has been the standard of care for over 60 years in the United States. However, parent refusal rates have been increasing with devastating effects. Here, we present a case of a 2-month-old male presenting to a pediatric emergency department with late-onset Vitamin K Deficient Bleeding secondary to parental refusal of prophylaxis at birth. The patient presented with a large intracranial hemorrhage due to Vitamin K deficiency. However, definitive neurosurgical operative repair was delayed due to profound coagulopathy. After Vitamin K and supportive blood products were administered in the emergency department and pediatric intensive care unit, the patient was stabilized for operative repair and has only minimal residual deficits at the most recent follow-up. This case report highlights the potentially devastating effects of Vitamin K Deficient Bleeding and how emergency department management may differ from other etiologies of intracranial hemorrhage. This is especially significant now given the broader rise in medical skepticism, which increasingly challenges longstanding, evidence-based preventive practices.