Neonatal intracerebellar hemorrhage after forceps delivery. Report of a case without neurologic damage

Neonatal intracerebellar bleeds are very rare and often seen in association with forceps or vaginal breech deliveries. Frequently the neonate requires surgical evacuation of the hemorrhage. These neonates are most often left with significant neurologic sequelae. Medical management has been reported but with poor outcomes.

A primigravida with a twin gestation delivered at 37 weeks. The delivery was facilitated by the use of low forceps for both infants. Twin B was diagnosed with a massive intracerebellar bleed on day 2 of life. She did not undergo surgical drainage due to an improvement in her clinical status. Follow-up examinations were completely normal, and the infant was developing normally at 2.5 years of age.

Low forceps deliveries can be associated with massive neonatal cerebellar hemorrhage, and these bleeds can be managed successfully without surgical drainage.