title: Clinical manifestations of symptomatic intracranial hemorrhage in term neonates: 18 years of experience in a medical center.
abstract: BACKGROUND
  Intracranial hemorrhage (ICH) is an uncommon but important cause of morbidity and mortality in term neonates. We conducted a retrospective analysis of the clinical characteristics and developmental outcomes of symptomatic ICH in term neonates.
  
  
  METHODS
  A retrospective chart review was conducted of all term neonates (less than 1 month old) diagnosed with ICH and admitted to the neonatal intensive care unit of Kaohsiung Chang Gung Hospital from December 1991 to December 2008. Demographic characteristics, mode of delivery, laboratory data, clinical presentation, and developmental status were recorded.
  
  
  RESULTS
  Data for 24 term neonates (17 boys and 7 girls) with a diagnosis of ICH were collected for analysis. The clinical manifestations of ICH included anemia (13/24, 54%), seizure (11/24, 46%), cyanosis (7/24, 29%), tachypnea (5/24, 21%), fever (1/24, 4%), hypothermia (1/24, 4%), and poor feeding (1/24, 4%). Age at symptom onset ranged from 2 hours to 11 days following birth. The most common type of ICH was subdural hemorrhage. All ICHs resolved, except in one infant, who died from hypoxicischemic encephalopathy at 25 days. Ten children with symptomatic ICH were reported to have normal development, while the remainder (13/23, 57%) showed developmental delays or disabilities.
  
  
  CONCLUSIONS
  Unexplained anemia, seizure, and cyanosis were the major presenting signs in infants with symptomatic ICH. A diagnosis of ICH should be considered in term neonates who present with one or more of these signs. Although the mortality in term infants with symptomatic ICH was low, more than half.
authors: Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Chiayi, Taiwan; Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors: Mei-Chen
authors: MC
authors: Ou-Yang
authors: Department of Pediatrics, Kuang Tien General Hospital, Taichung, Taiwan; Department of Nursing, Hung Kuang University, Taichung, Taiwan.
authors: Chung-Bin
authors: CB
authors: Huang
authors: Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors: Hsin-Chun
authors: HC
authors: Huang
authors: Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors: Mei-Yung
authors: MY
authors: Chung
authors: Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors: Chih-Cheng
authors: CC
authors: Chen
authors: Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors: Feng-Shun
authors: FS
authors: Chen
authors: Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors: Pei-Hsin
authors: PH
authors: Chao
authors: Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Chang Gung University College of Medicine, Kaohsiung, Taiwan.
authors: I-Lun
authors: IL
authors: Chen
authors: San An Hospital, Kaohsiung, Taiwan.
authors: Mei-Hui
authors: MH
authors: Ou-Yang
authors: Division of Neonatology, Department of Pediatrics, Chang Gung Memorial Hospital, Kaohsiung, Taiwan; Chang Gung University College of Medicine, Kaohsiung, Taiwan. Electronic address: liuca@adm.cgmh.org.tw.
authors: Chieh-An
authors: CA
authors: Liu
mesh_terms: D000367:Age Factors; D015331:Cohort Studies; D003422:Critical Care; D005260:Female; D005865:Gestational Age; D006760:Hospitalization; D006801:Humans; D007231:Infant, Newborn; D020300:Intracranial Hemorrhages / Q000175:diagnosis* / Q000209:etiology* / Q000628:therapy; D008297:Male; D012189:Retrospective Studies; D012307:Risk Factors; D016896:Treatment Outcome