title: Prevalence and evolution of intracranial hemorrhage in asymptomatic term infants.
abstract: OBJECTIVE
  Subdural hemorrhage (SDH) is often associated with infants experiencing nonaccidental injury (NAI). A study of the appearance and natural evolution of these birth-related hemorrhages, particularly SDH, is important in the forensic evaluation of NAI. The purpose of this study was to determine the normal incidence, size, distribution, and natural history of SDH in asymptomatic term neonates as detected by sonography (US) and MR imaging within 72 hours of birth.
  
  
  METHODS
  Birth history, delivery method, duration of each stage of labor, pharmaceutic augmentation, and complications during delivery as well as postnatal physical examination were recorded. Brain MR imaging and US were performed on 101 asymptomatic term infants at 3-7 days, 2 weeks, 1 month, and 3 months. Clinical follow-up at 24 months was recorded.
  
  
  RESULTS
  Forty-six neonates had SDH by MR imaging within 72 hours of delivery. SDH was seen in both vaginal and cesarean deliveries. All neonates were asymptomatic, with normal findings on physical examination. All 46 had supratentorial SDH seen in the posterior cranium. Twenty (43%) also had infratentorial SDH. US detected 11 of the 20 (55%) infratentorial SDHs and no supratentorial SDH. Most SDHs present at birth were <or=3 mm and had resolved by 1 month, and all resolved by 3 months on MR imaging. Most children with SDHs had normal findings on developmental examinations at 24 months.
  
  
  CONCLUSIONS
  SDH in asymptomatic term neonates after delivery is limited in size and location.
authors.affiliation: Department of Radiology, Tripler Army Medical Center, Honolulu, HI 96859-5000, USA. veronica.rooks@us.army.mil
authors.forename: V J
authors.initials: VJ
authors.lastname: Rooks
authors.forename: J P
authors.initials: JP
authors.lastname: Eaton
authors.forename: L
authors.initials: L
authors.lastname: Ruess
authors.forename: G W
authors.initials: GW
authors.lastname: Petermann
authors.forename: J
authors.initials: J
authors.lastname: Keck-Wherley
authors.forename: R C
authors.initials: RC
authors.lastname: Pedersen
mesh_terms: D001921:Brain / Q000000981:diagnostic imaging / Q000473:pathology; D004453:Echoencephalography / Q000706:statistics & numerical data*; D005260:Female; D006254:Hawaii / Q000453:epidemiology; D006801:Humans; D007231:Infant, Newborn; D020299:Intracranial Hemorrhage, Hypertensive / Q000151:congenital / Q000175:diagnosis* / Q000453:epidemiology*; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D015995:Prevalence; D018570:Risk Assessment / Q000379:methods*; D012307:Risk Factors