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Cerebral Hemorrhage in Newborns

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Neonatology

Abstract

Hemorrhagic lesions of the central nervous system (CNS) occur during the fetal, perinatal, and postnatal period. Due to the timing of the hemorrhage and the vulnerability of the developing brain, hemorrhagic lesions are associated with specific morbidity and mortality.

Germinal matrix hemorrhage-intraventricular hemorrhage (GMH-IVH) is still a common and serious condition in premature infants. Especially a large GMH-IVH, often complicated by posthemorrhagic ventricular dilation or associated with a unilateral parenchymal hemorrhage, is associated with an increased risk of adverse neurologic sequelae.

The widespread use of cranial ultrasonography since the early 1980s has shown a gradual decrease in the incidence of GMH-IVH and has helped with the identification of risk factors and timing of the lesion. The increased use of magnetic resonance imaging (MRI) has contributed to better define the site and extent of the lesion and to visualize associated white matter (WM) damage as well as associated cerebellar hemorrhages.

Hemorrhagic lesions of the CNS in the fetal period are associated with vascular malformation, thrombophilic disorders, and rarely brain malignancies. Perinatally acquired hemorrhagic CNS lesions in the full-term infant are associated with sinovenous thrombosis or traumatic parenchymal hemorrhage related to assisted vaginal deliveries.

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Abbreviations

CSF:

Cerebrospinal fluid

CSVT:

Cerebral sinovenous thrombosis

CT:

Computed tomography

cUS:

Cranial ultrasound

DQ:

Developmental quotient

DRIFT:

Drainage intervention fibrinolytic therapy

ECMO:

Extracorporeal membrane oxygenation

GMH-IVH:

Germinal matrix hemorrhage-intraventricular hemorrhage

HPI:

Hemorrhagic parenchymal infarction

iNO:

Inhaled nitric oxide

IPL:

Intraparenchymal Lesion

MRI:

Magnetic resonance imaging

NIRS:

Near-infrared spectroscopy

NAITP:

Neonatal alloimmune thrombocytopenia

PVHI:

Periventricular hemorrhagic infarction

PVL:

Periventricular leukomalacia

PLAI:

Platelet surface antigen

PLIC:

Posterior limb of the internal capsule

PHVD:

Posthemorrhagic ventricular dilatation

VI:

Venous infarction

VM:

Ventriculomegaly

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Authors and Affiliations

  1. Department of Neonatology, Wilhelmina Children’s Hospital, University Medical Center, Utrecht, The Netherlands

    Linda S. de Vries

  2. Department of Neonatology, Southmead Hospital, North Bristol NHS Trust, Bristol, UK

    Axel Heep

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  1. Linda S. de Vries
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  2. Axel Heep
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Correspondence to Linda S. de Vries .

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  1. Department of Pediatrics Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy

    Giuseppe Buonocore

  2. Department of Pediatrics Obstetrics and Reproductive Medicine, University of Siena, Siena, Italy

    Rodolfo Bracci

  3. Liverpool Women’s Hospital Neonatal Unit, Liverpool, UK

    Michael Weindling

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de Vries, L.S., Heep, A. (2018). Cerebral Hemorrhage in Newborns. In: Buonocore, G., Bracci, R., Weindling, M. (eds) Neonatology. Springer, Cham. https://doi.org/10.1007/978-3-319-29489-6_275

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