title: Spontaneous intracranial hemorrhage of structural origin during the first year of life.
abstract: Symptomatic intracranial hemorrhage (ICH) in term infants is not common, but when it occurs it is usually secondary to trauma, coagulation disorders and/or hypoxia. The possibility of a structural cause for an infantile ICH is unfortunately not seriously considered until very late. In this paper we report the cases of five full-term infants, each of whom developed ICH secondary to a structural lesion during the 1st year of life. Three presented during the newborn period. A congenital saccular aneurysm of the middle cerebral artery in an 8-month old male infant; a posterior fossa arteriovenous malformation in a 2-week old female neonate; a deep parietal cavernous angioma in a 6.5-month-old male infant; a temporoparietal low-grade astrocytoma in a 12-day old male neonate and a temporoparietal desmoplastic ganglioglioma in a 9-day-old male neonate were the structural lesions that were causative for hemorrhage. In all cases but one, the diagnosis was reached by computerized tomography and/or magnetic resonance imaging. All infants underwent surgery for the removal of the hematoma and of the lesion causative for the bleed. All are alive at 19, 3, 11.5, 10, and 5 years, respectively. We discuss the diagnosis of ICH with special emphasis on contemporary imaging modalities and stress the benefits of aggressive and timely surgical treatment. We then consider a concise analysis of the world literature on the occurrence of structural causes of ICH during infancy.
authors.affiliation: Division of Neurosurgery, Children's Hospital of Eastern Ontario, Ottawa, Canada.
authors.forename: I H
authors.initials: IH
authors.lastname: Tekkök
authors.forename: E C
authors.initials: EC
authors.lastname: Ventureyra
mesh_terms: D001165:Arteriovenous Malformations / Q000150:complications*; D001932:Brain Neoplasms / Q000150:complications / Q000473:pathology; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology*; D005260:Female; D018303:Ganglioglioma / Q000150:complications / Q000473:pathology; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D002532:Intracranial Aneurysm / Q000150:complications; D008279:Magnetic Resonance Imaging; D008297:Male; D014057:Tomography, X-Ray Computed; D014463:Ultrasonography