Intracranial haemorrhage in the term infant confirmed by computed tomography

Area of Science:

• Neonatal Neurology
• Pediatric Neurosurgery

Background:

• Intracranial haemorrhage (ICH) is a significant concern in neonates.
• Understanding the outcomes and management of ICH in term infants is crucial for clinical practice.

Purpose of the Study:

• To evaluate the clinical presentation, neurodevelopmental outcomes, and management of intracranial haemorrhage in term and postterm infants.
• To compare the incidence, mortality, and hydrocephalus development of ICH in term versus preterm infants.

Main Methods:

• Clinical diagnosis of ICH confirmed by computed tomography (CT) in 9 infants (8 term, 1 postterm).
• Neurodevelopmental assessment (psychomotor development) performed at follow-up ranging from 2.5 to 30 months.
• Comparison of findings with published data on ICH in preterm infants.

Main Results:

• ICH was diagnosed between days 2-12 of life; only one infant had birth asphyxia.
• One infant died, and another developed post-haemorrhagic hydrocephalus requiring a shunt.
• At follow-up, 6/8 infants had normal psychomotor development, 1 mild delay, and 1 marked delay.
• Mortality in preterm infants with ICH was 4.5 times higher than in term infants.
• Post-haemorrhagic hydrocephalus incidence was similar in surviving term and preterm infants.

Conclusions:

• Intracranial haemorrhage in term infants has a generally better prognosis than in preterm infants, with lower mortality rates.
• Repeated lumbar punctures show therapeutic success in preterm infants with post-haemorrhagic hydrocephalus and warrant consideration in term infants before shunting.
• Further investigation into etiologic factors and pathogenesis of ICH is needed.