[Primary intra-cerebral hemorrhage in the new born, nursling and child (author's transl)]
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Pediatric intracerebral hemorrhages, though rare, pose diagnostic challenges. Early CT scans improve detection and prognosis, but long-term outcomes remain uncertain due to potential recurrence and complications.
Area of Science:
- Neurology
- Pediatrics
- Radiology
Background:
- Intracerebral hemorrhages in children are uncommon, often presenting diagnostic and etiological challenges.
- Literature review highlights the sporadic nature and persistent uncertainties surrounding primary pediatric intracerebral hemorrhages.
Observation:
- This study details 6 cases of primary intracerebral hemorrhages in children, spanning neonates to adolescents.
- Computed tomography (CT) scanning proved effective in early lesion detection and guiding treatment decisions.
Findings:
- Prognosis is influenced by early diagnosis, hemorrhage size, hematoma location, patient neurological status, and absence of comorbidities.
- Long-term prognosis is uncertain due to high recurrence rates, potential hydrocephalus development, and frequent sequelae affecting cognitive functions.
Implications:
- CT scanning is crucial for timely diagnosis and management of pediatric intracerebral hemorrhages.
- Despite diagnostic advancements, long-term outcomes remain guarded, necessitating ongoing monitoring for recurrence and complications.
- Further research is needed to elucidate the long-term trajectory and management strategies for these rare pediatric conditions.
Abstract:
The authors report 6 cases of intracerebral hemorrhages in 6 children, of what appears to be, of primary origin. 3 cases concern children between the ages of 4 and 14 years; the 3 others are situated shortly after birth or during the first months of life. A review of the literature emphasizes the sporadic nature of these cases and the persistance of diagnostic and etiological problems as to the cause of these hemorrhages. In the course of reviewing articles as well as our own personal series, it is evident that the cat scanner has demonstrated its qualifications as a diagnostic tool in the early detection of the lesions, permitting a better adapted treatment, thus improving their prognosis. The prognosis appears to be linked : --to an early diagnosis --to whether or not the hemorrhage is of massive nature or not --to the precise location of the hematoma --to the neurological state of the patient at the time of treatment --to the absence of an associated pathologie (severe prematurity, coagulation pathology). The long distance prognosis in the case of these apparently primary hemorrhages remains uncertain, due to the high rate of recidivism at a later unpredictable date (one month or several years later); to the occurence or not of a hydrocephalus especially in the case of young infants; and frequent sequels affecting superior functions. This long distance prognosis seems, however, to be little affected by the recent acquisitions in diagnostic testing.