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Prognosis of intracranial hemnorrhage in neonates
Insights
Severe intraventricular hemorrhage (IVH) in infants is linked to mortality but not always to poor developmental outcomes in survivors. Many infants with IVH can still develop normally.
Area of Science:
- Pediatrics
- Neurology
- Medical Imaging
Background:
- Intracranial hemorrhage (ICH) is a serious condition in infants.
- Intraventricular hemorrhage (IVH) is a common type of ICH with potential long-term neurodevelopmental consequences.
- Computerized axial tomography (CAT) is used to diagnose ICH and IVH.
Purpose of the Study:
- To assess the developmental outcomes of infants surviving intracranial hemorrhage.
- To correlate the severity of intraventricular hemorrhage with mortality and developmental delay.
- To investigate the impact of severe IVH on long-term development in surviving infants.
Main Methods:
- Serial developmental assessments were conducted on infants who survived intracranial hemorrhage diagnosed via CAT scans.
- A grading system was used to categorize the severity of intraventricular hemorrhage.
- Outcomes were analyzed based on the presence and severity of IVH and hemorrhage location.
Main Results:
- Eleven of 21 infants with ICH survived and were assessed.
- Six of nine infants with IVH showed normal development.
- Severe IVH correlated more strongly with mortality than with developmental delay in survivors.
Conclusions:
- Intraventricular hemorrhage, even when severe, does not uniformly result in poor developmental outcomes for surviving infants.
- Infants with isolated subtentorial hemorrhage also demonstrated variable developmental trajectories.
- These findings challenge previous assumptions about the inevitable poor prognosis associated with severe IVH in neonates.
Abstract:
Eleven of 21 infants with intracranial hemorrhage documented by computerized axial tomography survived and have had serial developmental assessments. Six of nine infants with intraventricular hemorrhage (IVH) are developing normally, as is one of two infants with isolated subtentorial hemorrhage. According to our system for grading the severity of IVH, severe IVH correlated best with mortality and less well with developmental delay in survivors. Contrary to past impressions, IVH, even if severe, does not uniformly lead to a poor developmental outcome in surviving infants.