Intracranial Haemorrhage in the new-born: A study of diagnosis and differential diagnosis based upon pathological and clinical findings in 126 cases

Craig, W. S.

doi:10.1136/adc.13.74.89

Cited by 92 publications

(17 citation statements)

References 22 publications

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“…The incidence of intracranial hemorrhage is reported to be between 2.5 and 19.5% in neonates, and between 7.2 and 18% in mature infants [5, 6]. Fullerton et al [7 ]in a study of a California-wide hospital discharge database observed that the incidence rate of hemorrhagic stroke is 1.1 per 100,000 person-years, and 1.2 per 100,000 person-years for ischaemic stroke in children.…”

Section: Discussionmentioning

confidence: 99%

Spontaneous Intracranial Hemorrhage in Children

Kumar

Shukla

Mahapatra³

2009

Pediatr Neurosurg

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Aim: Spontaneous intracranial hemorrhage (SICH) in children is relatively less common as compared to adults, and there are limited studies addressing this issue in children. In this study, we analyze the etiology, clinical features, treatment options and outcome assessment in this population. Material and Methods: Fifty consecutive patients of spontaneous intracerebral bleed, aged 18 years and below, were retrospectively analyzed based on medical records and radiographic images. Status of the patient at the final follow-up after discharge was considered as the outcome. Results: Age of patients ranged from 2 months to 17 years with higher predilection in males (M:F = 3:2). Presenting features were symptoms of raised intracranial pressure (70.0%), deterioration in sensorium (50.0%), limb weakness (36.0%) and seizures (28%). Arteriovenous malformation (AVM) was the most common cause of hemorrhage, and was found in 22 patients (44%), followed by cerebral aneurysm in 17 cases (34%), moyamoya disease in 3 cases (6%), and intracranial tumor, hematological disorders and unknown cause (possible vasculitis) were each found in 2 patients (4%). Treatment modalities consisted of: excision of AVM, aneurysm clipping, embolization, superficial temporal artery to middle cerebral artery bypass, tumor excision, hematoma evacuation and conservative management. Thirty-five patients (74%) had good outcome and 13 patients had poor outcome (26%). Conclusions: Aneurysm is an important cause of SICH, alongside AVM, which is the leading cause. Thorough investigation is necessary to elucidate the cause of bleed, which may otherwise be missed. Cerebellar bleed and late presentation were found to be associated with poor outcome. Age was not found to be associated with outcome.

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Section: Discussionmentioning

confidence: 99%

Spontaneous Intracranial Hemorrhage in Children

Kumar

Shukla

Mahapatra³

2009

Pediatr Neurosurg

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“…Bridging vein rupture is uncommon: Craig described 120 neonatal autopsies with 62 showing SDH but only three with torn bridging veins, all with overriding sutures. 33 Larroche described 700 autopsies, 18% with SDH. 34 She noted a common association with hypoxic-ischaemic injury.…”

Section: Support For the Geddes Hypothesismentioning

confidence: 99%

Shaken baby syndrome: the quest for evidence

Squier

2007

Develop Med Child Neuro

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Shaken baby syndrome (SBS), characterized by the triad of subdural haemorrhage, retinal haemorrhage, and encephalopathy, was initially based on the hypothesis that shaking causes tearing of bridging veins and bilateral subdural bleeding. It remains controversial. New evidence since SBS was first defined three decades ago needs to be reviewed. Neuropathology shows that most cases do not have traumatic axonal injury, but hypoxic–ischaemic injury and brain swelling. This may allow a lucid interval, which traumatic axonal injury will not. Further, the thin subdural haemorrhages in SBS are unlike the thick unilateral space‐occupying clots of trauma. They may not originate from traumatic rupture of bridging veins but from vessels injured by hypoxia and haemodynamic disturbances, as originally proposed by Cushing in 1905. Biomechanical studies have repeatedly failed to show that shaking alone can generate the triad in the absence of significant neck injury. Impact is needed and, indeed, seems to be the cause of the majority of cases of so‐called SBS. Birth‐related subdural bleeds are much more frequent than previously thought and their potential to cause chronic subdural collections and mimic SBS remains to be established.

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“…A disturbed coagulation defect cannot be regarded as a prerequisite of simultaneous bleeding in more than one situation. The present study suggests that such bleeding is most frequently accounted for by circumstances favouring anoxia and that as previously stated (Craig, 1938) defects of coagulation are only very rarely of major importance in the causation of intracranial haemorrhage. Sanford (1948) states he has never seen a case of cerebral haemorrhage with coagulation dysfunction.…”

Section: On Real and Apparent External Bleeding In The Newbornmentioning

confidence: 54%