Intracranial hemorrhage: clinical and demographic features of patients with late hemorrhagic disease.
BACKGROUND
This retrospective study presents clinical, demographical features and radiological findings as well as outcomes of 31 infants with intracranial hemorrhage (ICH) due to vitamin K deficiency and hence evaluates the risk factors involved.


METHODS
Thirty-one cases (17 males and 14 females) having a mean age of 52.52 ± 20.80 days with intracranial hemorrhage due to late hemorrhagic disease of the newborn (LHDN), hospitalized in our clinics were included in the study. Cranial computerized tomography (CT) was performed in all patients for the diagnosis and evaluation of ICH.


RESULTS
It was found that the most frequent presenting symptoms were pallor (77.4%), seizures (58%), altered consciousness (58%), vomiting (44%) and poor feeding (35%). Pulsatile fontanel was found in 61% and bulging in 26%. Seven (22.5%) patients had prior history of antibiotic usage. All patients (93.5%) except two were breast fed. Sixteen (51.6%) were delivered at home. Eighteen (58%) had a history of single-dose vitamin K prophylaxis on the first day of delivery. Parenchymal (44%), subdural (39%) or subarachnoidal (22.5%) bleeding was observed. Seven (22.6%) were exitus. During the follow-up period (ranging from 3 months to 18 months) neurological examination findings were recorded.


CONCLUSIONS
Our results indicate that it may be questionable whether single-dose vitamin K prophylaxis at birth is adequate for the prevention of LHDN and if a different timing of this prophylaxis should be made for the exclusively breast fed infants.
Pirinccioglu
Ayfer Gözü
AG
Department of Pediatrics, University of Dicle, Diyarbakir, Turkey. ayfergozu@dicle.edu.tr
Gurkan
Fuat
F
Bosnak
Mehmet
M
Acemoglu
Hamit
H
Davutoglu
Mehmet
M
D005260:Female; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D020300:Intracranial Hemorrhages / Q000175:diagnosis / Q000209:etiology* / Q000517:prevention & control; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D014057:Tomography, X-Ray Computed; D014421:Turkey; D014812:Vitamin K / Q000627:therapeutic use; D006475:Vitamin K Deficiency Bleeding / Q000175:diagnosis* / Q000517:prevention & control; D014815:Vitamins / Q000627:therapeutic use
D014815:Vitamins; D014812:Vitamin K