Intracranial bleeding is common in premature babies, especially those born before 32 weeks of gestation. However, they also not infrequently appear in term newborns, especially if the delivery was not going well. What are the causes and symptoms of intracranial bleeding? What is the treatment?

Intracranial bleeding in newbornsis a very common complication of prematurity - it occurs in about half of newborns born prematurely. They can also appear in full-term babies, especially if the birth was not going well.

Neonatal intracranial bleeding - types

  • intraventricular / periventricular- are the most common cause of damage to the central nervous system in premature babies. In children born before 32 weeks of gestation and / or with a birth weight less than 1500 g, the frequency of this type of bleeding is 35-45%. They are very rare in babies born near or at term. Most hemorrhages (90%) occur within the first 3 days of a newborn's life. There are IV degrees of intraventricular bleeding - from mild, which may not cause any complications, to very severe, which may be fatal;
  • subarachnoid- usually accompanies other types of bleeding, the most common in preterm newborns. Its incidence is estimated at 14-16%. all CNS bleeding in newborns;
  • subdural(between the dura mater and the arachnoid) - in most cases it occurs in full-term newborns;
  • epidural(between the dura mater and the skull) - the least frequent;

Neonatal intracranial bleeding - causes

Intracranial bleeding in premature babies may be the result of underdevelopment of the brain vessels (and thus - cerebral circulation disorders), vitamin K deficiency or respiratory distress syndrome. Mechanical ventilation (connection to a ventilator) of a premature baby is a risk factor, especially if its parameters are high.

Another cause of intracranial bleeding (not only in premature babies, but also in full-term babies) is perinatal head trauma. Other reasonsintracranial bleeding in newborns is cerebral hypoxia, various types of birth defects, vascular malformations, increased intracranial pressure, infections and coagulation disorders.

Neonatal intracranial bleeding - symptoms

  • increased intracranial pressure (tense, throbbing anterior cap, divergence of cranial sutures);
  • vomiting;
  • muscle tension disorders (e.g. in the form of placing the child in the so-called frog position);
  • convulsions (most often in subarachnoid bleeding);
  • loud scream, referred to as "brain scream";
  • other severe neurological symptoms (breathing disorders, throwing back the head back, pupil stiffness, turning the eyeballs "towards the hemorrhage", optic disc swelling - with subdural hemorrhage);
  • sleep apnea;
  • cyanosis;
  • symptoms of hydrocephalus;

Neonatal intracranial bleeding - diagnosis

Trans-gland ultrasound examinations (trans-gland ultrasound) and examination of the cerebrospinal fluid are performed.

Neonatal intracranial bleeding - treatment

Stage I and II bleeding is usually self-absorbing, therefore no medical intervention is needed. In other cases, treatment is applied to alleviate the symptoms of bleeding.

Neonatal intracranial bleeding - prognosis

The prognosis depends on the degree of bleeding and damage to the central nervous system. In the case of minor bleeding, the prognosis is comparable to that of newborns born in the same period of pregnancy without bleeding. Stage III bleeding carries a risk of hydrocephalus, cerebral palsy, hearing and vision damage, or psychomotor development disorders. Stage IV bleeding can even lead to death (risk is 80-90%).

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