title: [Non-traumatic cerebral hemorrhage in childhood: etiology, clinical manifestations and management].
abstract: OBJECTIVE
  Non-traumatic intracranial hemorrhage is a rare occurrence in children, with the most frequent etiology being vascular malformation. Our aim was to review the etiology and management of spontaneous cerebral hemorrhage in children.
  
  
  METHODS
  We have reviewed the patients admitted to our intensive care unit (ICU) with spontaneous intracranial hemorrhage from 1980 to 1998. The etiology, symptoms and their clinical management were analyzed.
  
  
  RESULTS
  Forty patients with non-traumatic intracranial hemorrhage were admitted during this time period. The mean age was 6.8 years and the male/female ratio was 2.4/1. This condition presented with a sudden onset in 83%. The most common form of presentation was headache, vomiting and altered consciousness. The most frequent etiology was vascular malformation (32.2%). Initial management was symptomatic and addressed the prevention or treatment of intracranial hypertension and seizures. Mortality was 38% and there were sequelae in 35%.
  
  
  CONCLUSIONS
  Management of critical non-traumatic intracranial hemorrhage consists in preventing or treating cerebral hypertension. The monitoring of intracranial pressure, jugular oxygen saturation and transcranial Doppler allows an indirect measurement of cerebral blood flow. Prompt excision of the hematoma improves the outcome. In vascular malformations, endovascular embolization or radiosurgery are possible.
authors.affiliation: Servicio de Pediatría, Hospital Sant Joan de Déu, Esplugues, Barcelona.
authors.forename: M E
authors.initials: ME
authors.lastname: May Llanas
authors.forename: E
authors.initials: E
authors.lastname: Alcover Bloch
authors.forename: F J
authors.initials: FJ
authors.lastname: Cambra Lasaosa
authors.forename: J
authors.initials: J
authors.lastname: Campistol Plana
authors.forename: A
authors.initials: A
authors.lastname: Palomeque Rico
mesh_terms: D000293:Adolescent; D001921:Brain / Q000000981:diagnostic imaging; D002533:Cerebral Angiography; D002543:Cerebral Hemorrhage / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D002648:Child; D002675:Child, Preschool; D004621:Embolization, Therapeutic; D005260:Female; D006406:Hematoma / Q000175:diagnosis / Q000209:etiology / Q000601:surgery; D006801:Humans; D007223:Infant; D002538:Intracranial Arteriovenous Malformations / Q000150:complications / Q000601:surgery / Q000628:therapy; D007427:Intracranial Pressure; D008297:Male; D016634:Radiosurgery; D014057:Tomography, X-Ray Computed
vernacular_title: Hemorragia cerebral no traumática en la infancia: etiología, manifestaciones clínicas y manejo.