Vitamin K deficiency--late onset intracranial haemorrhage.
A retrospective study is presented of the clinical features and outcome of late onset haemorrhagic disease due to vitamin K deficiency in 11 babies who were admitted to the emergency or child neurology unit during a 4-year period (January 1994-December 1997). The disease occurred in infants between 30 and 119 days of age (mean: 56+/-24 days). None of them received vitamin K after birth and all were breastfed. The presenting complaints were seizures (91%), drowsiness (82%), poor sucking (64%), vomiting (46%), fever (46%), pallor (46%), acute diarrhoea (27%), irritability and high-pitched cry (18%). On examination, tense or bulging fontanelle (73%), anisocoria (36%), weak neonatal reflexes (18%), cyanoses (18%) were the most frequent findings. The localizations of the intracranial haemorrhage were as follows: intracerebral (91%), subarachnoid (46%), subdural (27%), and intraventricular (27%). No fatality was observed. However, after a follow-up period ranging from 6 to 48 months (mean: 21+/-13 months), only three (27%) infants remained neurologically normal. Seizure disorders (73%), severe psychomotor retardation (46%), cerebral palsy (46%) and microcephaly (46%) were observed in the remainder. Hydrocephalus developed in three (27%) babies but none of them required shunt replacement. The value is emphasized of vitamin K prophylaxis in the newborn to reduce the incidence of late onset intracranial haemorrhage and handicap in children.
Aydinli
N
N
Department of Paediatrics, Institute of Child Health, Istanbul University, Turkey.
Citak
A
A
Calişkan
M
M
Karaböcüoglu
M
M
Baysal
S
S
Ozmen
M
M
D005500:Follow-Up Studies; D006801:Humans; D007223:Infant; D020300:Intracranial Hemorrhages / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D012189:Retrospective Studies; D014057:Tomography, X-Ray Computed; D014812:Vitamin K / Q000627:therapeutic use; D014813:Vitamin K Deficiency / Q000150:complications*
D014812:Vitamin K