Brain hemorrhage in newborns

Births are difficult, though a physiological process, and always unpredictable. Various adverse factors can affect pregnancy and the birth itself, causing complications. One of the most dangerous is the brain hemorrhage of the newborn, or cephalohematoma.

Causes and risk factors

Bleeding in the brain, just born baby may be a consequence of pathologically proceeding pregnancy or birth trauma. The risk of intracranial hematomas exist in the first week of life. The main mechanisms influencing the formation of intracerebral hematoma in neonates:

  • abnormal pregnancy in which the fetus is suffering from intrauterine infection with microorganisms affecting the vascular wall, either from hypoxia (oxygen starvation);
  • the birth of a premature or, conversely, post-term infant;
  • large fruit with inappropriate size of the baby’s head and the birth canal of the mother;
  • childbirth with a breech presentation;
  • rapidly deliveries;
  • the protracted process of labor activity;
  • the use of the obstetric forceps, the errors of health workers in the management of labor;
  • a cesarean delivery.

The types of pathology

  • An epidural hemorrhage. Occurs as a result of vascular injury and rupture of blood in the space between the outer brain membrane and the skull. Cause fractures, bruises, compression of the cranial vault. Characteristic symptoms appear after a «lucid interval» in 3 – 6 hours. Then observed a dilated pupil on the affected side, depression of cardiac and respiratory activity, convulsions. Treatment should begin immediately after detection of these symptoms, otherwise the child will fall into a coma.
  • Intracranial (intracerebral) hemorrhage. The outpouring of blood takes place directly in the brain tissue. Symptoms will depend on the location of the hematoma – affected area of the brain ceases to control the functions of the body for which it is responsible.
  • Intraventricular hemorrhage is one of the worst, when the blood fills the cavity of the cerebral ventricles are filled with CSF (cerebrospinal fluid). This complication is more common in infants with a profound degree of prematurity. Mild there may be no symptoms. Moderate and severe pathology threatens to stop breathing and collapse (a sharp fall in blood pressure). The consequences may be hydrocephalus, loss of the sucking, swallowing and tendon reflex.
  • Subdural hemorrhage occurs when the damaged blood vessels and outpouring of blood into the space between the hard and soft shell of the brain (more precisely, hematoma formed under the hard shell). There are characteristic symptoms: head sizes are rapidly increasing, there is hypertension with hemorrhage in the sclera of the eyes and convulsions. This condition requires urgent actions for rescue and treatment of the newborn.
  • Subarachnoid hemorrhage. Vascular injury and rupture of blood in the slit-like space between the substance of the brain and the arachnoid membrane. When subduralna hemorrhage symptoms appear immediately and includes the initiation of a newborn with a permanent Creek, the divergence of the eyeballs, enlarged head, convulsions. Condition requires immediate action, but timely medical aid consequences for the proper development of the infant is minimal.
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    Symptoms of bleeding into the brain in newborns

    For any kind of brain hemorrhage in newborns characterized several common symptoms that indicate the presence of pathology:

    • lethargy, detachment, lethargy behavior;
    • frequent regurgitation and vomiting;
    • cramps due to compression of brain tissue.

    When hemorrhage into the deeper parts of the brain will be observed:

    Hypertension is no longer a disease?

    Doctors are shocked by the statement, the chief cardiac surgeon in the country Leo Beaucaire.

      Кровоизлияние в мозг у новорожденных

    • oppression to a complete absence of pupillary reaction to light;
    • a sudden disturbance of function of limbs on the same (affected) side of hemiplegia;
    • slowing of the cardiac rhythm – the development of bradycardia;
    • the development of hypothermia – lowering the temperature of the body;
    • a violation of the respiratory rhythm;
    • falling into a state of deep coma.

    In hemorrhages in the substance of the brain (grey and/or white):

    • accordionist in space;
    • irritability or sudden confusion;
    • the appearance of hemiplegia;
    • pathological stopnye syndromes (reflex extension of the toes with light tapping on it).

    Hemorrhage in the tissue of the cerebellum:

    • disturbed consciousness;
    • constricted pupils;
    • tension of the occipital muscles with rotated head position back or to the side;
    • persistent evasion of view;
    • uncontrollable vomiting;
    • uncoordinated movements.

    Кровоизлияние в мозг у новорожденных

    Bleeding in the adrenal glands

    Such a pathological condition in newborns, occurs when the forceps and other supplementary benefits in childbirth and also in the breech. Passing through the birth canal, the child receives an injury to internal organs and rupture of blood vessels. The «bright period» without any symptoms lasts about two days. Then comes the sharp deterioration of the newborn:

    • muscle hypotonia or atony (lack of tone);
    • atony of the intestine;
    • bloating;
    • repeated regurgitation and vomiting;
    • a drop in blood pressure with inhibition of consciousness.
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    Methods of diagnosis of hemorrhage:

    • computed tomography;
    • lumbar puncture with subsequent analysis of liquor;
    • blood tests: coagulation, General and detailed analysis;
    • electroencephalography.

    Treatment

    Therapeutic measures are aimed at stopping bleeding, normalization of the functioning of the Central and peripheral nervous system, restoration of the respiratory system, cardiovascular system, adrenal glands, which suffer not only when hemorrhage directly in their tissue, but also in intracranial hematomas. Therapies can include the following:

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    • infusion of blood substitutes (isotonic sodium chloride solution, ringer solution);
    • the introduction of diuretics (Diacarb, Lasix);
    • lumbar puncture to reduce intracranial pressure;
    • introduction hemostatic drugs (aminocaproic acid, etamzilat sodium Menadione);
    • in adrenal insufficiency – introduction of the steroid drug Hydrocortisone (adrenal hormone);
    • when excited by the introduction of tranquilizers and sedative drugs (Droperidol, Phenobarbital, Diazepam);
    • the introduction of products with micro — and macroelements (potassium chloride, magnesium sulfate, calcium gluconate).

    In extremely severe cases, according to the testimony surgical treatment – excision of the hematoma.

    Rehabilitation

    After suffering a hemorrhage in children require the supervision of a neonatologist, a neurologist, and then as a pediatrician. Need careful maintenance, required daily massage with gymnastics. At an older age if needed, lessons with a speech therapist to establish a correct speech function.