Intracranial hemorrhage and vitamin K deficiency in early infancy

Area of Science:

• Pediatrics
• Neurology
• Hematology

Background:

• Vitamin K deficiency is a known cause of bleeding disorders in infants.
• Late-onset vitamin K deficiency bleeding can manifest as intracranial hemorrhage.
• Breast-fed infants are at higher risk if not supplemented with vitamin K.

Purpose of the Study:

• To describe the clinical presentation and neuroimaging findings of late-onset intracranial hemorrhage due to vitamin K deficiency in exclusively breast-fed infants.
• To emphasize the necessity of vitamin K prophylaxis in preventing such severe neurological events.

Main Methods:

• Retrospective case series of 32 infants presenting with late-onset intracranial hemorrhage.
• Review of clinical histories, focusing on feeding practices and vitamin K prophylaxis.
• Analysis of computerized tomography (CT) scans to characterize the type and severity of hemorrhage.

Main Results:

• 32 breast-fed infants (age 0.5-6 months) were diagnosed with intracranial hemorrhage.
• 31 out of 32 infants had not received prophylactic vitamin K at birth.
• Subarachnoid hemorrhage was the most common type (90.6%), often in combination with subdural, parenchymal, or intraventricular hemorrhage.
• Infratentorial hemorrhage was observed in 9.4% of cases.

Conclusions:

• Late-onset intracranial hemorrhage is a significant risk in exclusively breast-fed infants lacking vitamin K prophylaxis.
• Subarachnoid hemorrhage is the predominant finding, but other forms of intracranial bleeding can occur.
• Universal vitamin K prophylaxis at birth is crucial for preventing severe neurological complications in infants.