Purpose or Case Report: To delineate the spectrum of intra cranial imaging findings in infants with late hemorrhagic disease of newborn (late HDN)
Methods & Materials: A retrospective study of infants from January 2003 to February 2014, fulfilling the criteria of late HDN with CNS symptoms was done. None of them had history of vitamin k injection at birth. They were evaluated for the pattern and location of the bleed, infarcts, cerebral edema and mass effect. Hematological parameters were noted in all infants. Condition at the time of discharge and follow up imaging findings were also noted.
Results: Out of 24 infants (20 males and 4 females), 16 presented with intracranial bleed only, while 8 had bleed involving both CNS and other sites. Among intracranial hemorrhage 22 subdural hemorrhage, 19 subarachnoid hemorrhage, 8 parenchymal, and 5 intraventricular hemorrhage pattern were observed. Temporal lobe is the commonest parenchymal location, followed by frontal lobe. Combination pattern of hemorrhage (19 infants) was commoner than single location hemorrhage, most common being subdural hemorrhage and subarachnoid hemorrhage. Infarcts were seen in 10 infants and significant midline shift in 11 infants. 17 were discharged in stable condition. 7 were discharged against medical advice in view of poor prognosis. 2 underwent surgery, of which one recovered completely. 7 infants had follow up imaging, of which 5 showed cystic encephalomalacia and 2 had subdural hygroma
Conclusions: This study shows the various findings in a potentially preventable cause of intracranial bleed. In some parts of world, infants still suffer from this disease due to various factors related to maternal, neonatal and socio-economic conditions. Vitamin K dose at birth can prevent catastrophic neurological complications in these infants.