Intracranial hemorrhage in the prematurely born infant

Tsiantos, Alex; Victorin, Lars; Relier, Jean-Pierre; Dyer, N. H.; Sundell, Håkan; Brill, A. B.; Stahlman, Mildred T.

doi:10.1016/s0022-3476(74)80360-4

Cited by 114 publications

(27 citation statements)

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“…Developmental age/chronologieal age of infants with PHH Discussion PHH is a serious problem in survivors of IVH [16], a complication which is frequent in premature infants during the first few days of life [3,14]. The prevention of IVH thus appears to be the best treatment, but difficult since IVH is a poorly understood condition despite many studies to establish its etiology [1,8,11,13].…”

Section: Resultsmentioning

confidence: 99%

“…The infants may have seizures, fall in hemoglobin level, acidosis, hypoxia, apnea and bradycardia, among other signs and symptoms [2,14], The clinical diagnosis may be confirmed by ventricular tap or by computerized axial tomography (CT scan) [7], Abnormal increase in head size, a late complication, was noted at a mean interval of 14.5 days from the diagnosis of IVH. Korobkin [6] has reported a similar experience.…”

Section: Resultsmentioning

confidence: 99%

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Early Surgical Intervention in Posthemorrhagic Hydrocephalus

Bada¹,

Salmon²,

Pearson³

1979

Pediatr Neurosurg

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10 premature infants were found to have posthemorrhagic hydrocephalus (PHH) over a 4-year period. All weighed less than 2,500 g. The diagnosis was established by ventricular puncture and ventriculogram. Ventriculo-peritoneal (V-P) shunt placement was done in each infant soon after establishing the diagnosis, while the cerebrospinal fluid (CSF) was bloody. The mean age of infants at surgery was 21.4 days (range 16–33 days). Shunt obstruction occurred in 3 infants and infection in 1. No other complication was observed. All infants improved markedly in the immediate postoperative period, especially respirator-dependent infants. All survived; preliminary follow-up revealed that 3 were severely retarded and 2 mildly retarded; 5 infants were normal. Our preliminary experience with early V-P shunt procedure in the treatment of PHH has been favorable and follow-up appears encouraging.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Early Surgical Intervention in Posthemorrhagic Hydrocephalus

Bada¹,

Salmon²,

Pearson³

1979

Pediatr Neurosurg

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“…De acordo com a literatura 11,14,15 , queda significativa nos hematócritos das mesmas crianças, antes e após o evento hemorrágico, demonstrou, no presente estudo, estar fortemente associada à presença da hemorragia (p = 0,03). No entanto, ao serem avaliados os hematócritos das crianças sem ocorrência de HPIV, nota-se que 5 de 31 casos (16%) apresentaram queda maior que o valor da média da queda entre os que tiveram hemorragia.…”

Section: Discussionunclassified

The unreliability of neurologic examination in the diagnosis

Tavares¹,

Correa²,

Viana³

1998

J Pediatr (Rio J)

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ResumoObjetivo: Avaliar a eficácia do exame clínico-neurológico, do hematócrito e da glicemia no diagnóstico das hemorragias periintravasculares nos recém-nascidos com peso abaixo de 2000 g, considerando-se o exame ultra-sonográfico transfontanelar como padrão ouro.Métodos: Estudo prospectivo, tipo coorte, realizado no Hospital das Clínicas da UFMG no período de 18/05/94 a 17/05/95. O grupo de estudo constou de 38 crianças com diagnóstico ultrasonográfico de HPIV, e o grupo controle, de 81 crianças submetidas ao mesmo protocolo de avaliação, porém sem sinais ecográficos de HPIV. Os exames ultra-sonográficos foram realizados pelo pesquisador sem conhecimento prévio da história clínica ou dos exames clínico-laboratoriais.Resultados: As alterações no exame clínico-neurológico, especialmente o achado de hipotonia, mostraram-se associadas à presença de HPIV (p = 0,009), mas foi observado um efeito de confusão com a idade gestacional do recém-nascido. O baixo poder de predição positiva e negativa (45% e 79%, respectivamente) torna o exame clínico-neurológico pouco confiável no diagnóstico da hemorragia. O hematócrito e a glicemia não foram também de relevân-cia clínica.Conclusões: O exame clínico-neurológico mostrou-se insuficiente para sugerir o diagnóstico de HPIV, sendo recomendável o rastreamento rotineiro, com ultra-sonografia transfontanelar, dos recém-nascidos de risco. J. pediatr. (Rio J.). 1998; 74(1):25-30: recém-nascido, prematuro, hemorragia cerebral, ultra-sonografia. AbstractObjective: To evaluate the efficacy of the clinical neurologic examination, hematocrit and glycemia in the diagnosis of periventricular-intraventricular hemorrhage in the newborn weighing less than 2000g considering the neurosonography as the gold standard.Methods: This is a cohort prospective study from May 18 th , 1994 to May 17 th , 1995 carried out at the Hospital das Clinicas da UFMG. The study group comprised 38 newborns with the ultrasound diagnosis of periventricular-intraventricular hemorrhage; the control group comprised 81 newborns who although submitted to the same evaluation protocol did not show any echographic signs of hemorrhage. The ultrasound examinations were all done by the same researcher who was not aware of the clinical history or the neurologic and laboratory examinations.Results: Clinical neurologic alterations, mainly generalized hypotonia, were found to be associated with hemorrhage (p = 0.009), but there was a confounding effect due to the gestational age of the newborn. The predictive values of a positive or negative test were only 45% and 79%, respectively, which is clearly unreliable for the diagnosis of the hemorrhage. Hematocrit and glycemia were not clinically relevant either. Conclusions:The clinical neurologic examination is not reliable to indicate periventricular-intraventricular hemorrhage in the newborn. Newborns at risk should be routinely screened by neurosonography.J. pediatr. (Rio J.). 1998; 74(1):25-30: infant newborn, infant premature, cerebral hemorrhage, ultrasonography. diagnóstico...

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“…Because of the interval required for clot formation, serial ultrasound examinations of the infant for up to four days of age may be required to detect the presence of hemorrhage. TSIANTOS et al [21] routinely labeled erythrocytes of neonates with Chromium 51 within the first few hours of life and found that 60% of the hemorrhages took place between 15 and 48 hours of age. FUJIMURA et al [9] using hemoglobin as a marker, observed that infants less than 28 week's gestation were more likely to sustain PIVH in the first 24 hours of life than infants of greater gestational age.…”

Section: Discussionmentioning

confidence: 99%