Brain haemorrhage in five infants with coagulopathy
- 1Gloucestershire Hospitals NHS Trust, Gloucester, UK
- 2Oxford Radcliffe Hospitals NHS Trust, Oxford, UK
- 3South Buckinghamshire NHS Trust, High Wycombe, UK
- 4Kettering General Hospital NHS Trust, Kettering, UK
- Correspondence to:
Dr E B A Vorstman
Gloucestershire Hospitals NHS Trust, Department of Paediatrics, Great Western Road, Gloucester, UK; ewoud.vorstmangloucr-tr.swest.nhs.uk
- Accepted 3 May 2003
Abstract
Most intracranial haemorrhages in infants after the neonatal period are secondary to non-accidental injury. Occasionally brain haemorrhages in non-mobile infants are due to an inherited coagulopathy. This may often be diagnosed with a coagulation screen on admission. Little is known about the neurological outcome of infants in the latter group.
Five infants are described who presented with acute spontaneous brain haemorrhage secondary to an inherited coagulopathy (n = 3) and vitamin K deficiency in α1 antitrypsin deficiency (n = 1) and Alagille’s syndrome (n = 1). Despite the critical clinical presentation and the severe imaging findings, these five infants made a good neurological recovery.
Infants presenting with spontaneous ICH due to a significant (inherited) coagulopathy are usually easy to differentiate from non-accidental shaking injury; their bleeding pattern within the brain seems different from non-accidental shaking injury and neurodevelopment outcome appears better.
