Intracranial Hemorrhage Caused by Vitamin K Deficiency Beyond Neonatal Period

Adhikari, Sudhir; Gauchan, Eva; Malla, Tejesh; Sathian, Brijesh; Rao, Kalipatanam Seshagiri

doi:10.3126/jnps.v37i1.16301

Cited by 2 publications

(4 citation statements)

References 9 publications

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“…The blood test results of all patients showed anemia and another previous study [14] revealed the same result. PRC transfusion can improve hemoglobin immediately to the normal range.…”

Section: Discussionsupporting

confidence: 76%

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The Glasgow Outcome Scale-Extended Pediatric Scores of Intracranial Bleeding Patients with Acquired Prothrombin Complex Deficiency Post Craniotomy and Duraplasty

Sinurat

2020

Pediatr Neurosurg

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Introduction: Surgical evacuation of intracranial bleeding in pediatric patients due to acquired prothrombin complex deficiency (APCD) is a life-saving surgery when conservative treatment insufficient and impending brain herniation. This study aimed to evaluate the Glasgow outcome scale-extended pediatric (GOS-ePed) score of the pediatric intracranial bleeding patients with APCD after craniotomy and duraplasty. Method: This was a retrospective study in the last 5 years of our experience. All of the pediatric patients with intracranial bleeding due to APCD who needed surgery were investigated. The data were collected from medical records after their parents have given their written informed concern and approved by the Ethics Review Committee, Faculty of Medicine, Universitas Kristen Indonesia. The inclusion criteria were patients who operated on by craniotomy and duraplasty. The patient with a second disease was excluded. Blood tests include hemoglobin, prothrombin time, activated prothrombin time, and platelets were investigated before and after intravenous vitamin K injection, transfusion packed red cells (PRCs), and fresh frozen plasma (FFP) administration. The Glasgow coma scale (GCS) pre- and postoperatively was evaluated using a modified GCS for infants and children. The outcome was evaluated by the GOS-ePed score. All data were analyzed with the normality test and paired t test. Results: There were 5 patients age between 37 and 60 days, and all patients did not get vitamin K prophylaxis after birth. The blood tests of all patients revealed anemia, prothrombin, and activated prothrombin time increased, but platelets were normal. All these values returned to normal after vitamin K injection, transfusion of PRCs, and FFP. The paired t tests were p < 0.05. The GCS of all patients before surgery was 8 or below. After surgery, the GCS of 4 patients was increased become 12 and 15. One patient did not change significantly. The GOS-ePed score showed 4 patients (80%) had upper or lower good recovery, and 1 patient (20%) was in a vegetative state. Conclusions: The GOS-ePed score of the pediatric intracranial bleeding with APCD after craniotomy and duraplasty was mostly in upper or lower good recovery.

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“…The blood test results of all patients showed anemia and another previous study [14] revealed the same result. PRC transfusion can improve hemoglobin immediately to the normal range.…”

Section: Discussionsupporting

confidence: 76%

“…The results of this study revealed GOS-ePed score of 80% of patients was between upper and lower good recovery, without death. It was better than other previous studies have reported [6,10,14,15]. The mortality rate was from 12 to 25%.…”

Section: Discussioncontrasting

confidence: 55%

The Glasgow Outcome Scale-Extended Pediatric Scores of Intracranial Bleeding Patients with Acquired Prothrombin Complex Deficiency Post Craniotomy and Duraplasty

Sinurat

2020

Pediatr Neurosurg

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“…This case series, with other report of VKDB in Nepal [27] , should be taken as an evidence of a cause specific occurrence of infant deaths which can be prevented through a simple and affordable intervention. The relatively low proportion (57.4%) of institutional delivery [2] would be a challenge to effectively deliver a birth dose injection of VK.…”

Section: Discussionmentioning

confidence: 63%

“…In countries without such national policy, like Nepal, only some children delivered in the private sector may get this affordable life-saving intervention, which is not equitable. A tertiary referral centre in Nepal identified 16 cases of ICH due to VKDB, of which only 3 (18.7%) had received VK at birth [27] . In current series, we could be certain about only one out of 16 (6%) infants of having received VK at birth.…”

Section: Discussionmentioning

confidence: 99%

Vaccine safety surveillance informs public health policy beyond immunization: A case-series on bleeding following vaccination, Nepal, 2016–2018

Pradhan

Gautam

Tinkari

et al. 2020

Vaccine

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Highlights Sixteen AEFI cases (21%) with symptom or sign of bleeding were reported in 2016–2018. Six (38%) had intra-cranial haemorrhage; 14 (88%) had bleeding from injection site. Only one case (6%) had confirmed history of receiving vitamin K at birth. Three (19%) were classified as late onset VKDB; 11 (69%) as suspected late onset VKDB. Nine cases (56%) resulted in death; among cases with VKDB diagnosis, eight (57%) died.

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Intracranial Hemorrhage Caused by Vitamin K Deficiency Beyond Neonatal Period

Abstract: Vitamin K deficiency bleeding (VKDB) can manifest as intracranial hemorrhage (ICH) and is still prevalent in poor resource countries. Infants aged one to twelve months with

Cited by 2 publications

References 9 publications

The Glasgow Outcome Scale-Extended Pediatric Scores of Intracranial Bleeding Patients with Acquired Prothrombin Complex Deficiency Post Craniotomy and Duraplasty

The Glasgow Outcome Scale-Extended Pediatric Scores of Intracranial Bleeding Patients with Acquired Prothrombin Complex Deficiency Post Craniotomy and Duraplasty

Vaccine safety surveillance informs public health policy beyond immunization: A case-series on bleeding following vaccination, Nepal, 2016–2018

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