Analysis Of The Etiology Of Nontraumatic Intracranial Hemorrhage In Children Below 2 Years Old

Objective:Through retrospective analysis of clinical characteristics for children below 2 years old with nontraumatic intracranial hemorrhage, discussion can be made for the etiology and related effects, aiming to be helpful for early diagnosis of young group in nontraumatic intracranial hemorrhage cases.Methods :According to the diagnostic criteria on cerebral hemorrhage in "Pediatric department of internal medicine" 、related diagnosis and the corresponding code, cases of nontraumatic intracranial hemorrhage in infants under the age of 2 years in two centers from December 2008 to January 2014 are selected. Clinical characteristics、influencing factors and diagnosis are recorded. Using statistical software SPSS20.0 to analyze the data, analysis of digital data is achieved by using Fisher’s exact test, the influence factors are successively bringing into univariate and multivariate non conditional Logistic regression analysis.Results : A total of 136 patients with nontraumatic intracranial hemorrhage are acquired under the age 0f 2 years,including newborns(aged less than 28 days) in 67 cases, infants(> 28 days < 2 years) in 69 cases. Average age of neonatal group was 4.47 days, including 54 cases(80.60%) under the age of 7 days.the average age of infants group is 78.54 days, including 58 cases(84.06%) aged from 1-3 months. By analysis, symptoms and signs of intracranial hemorrhage in two groups constitute difference(P < 0.001). For symptoms, abnormal complexion、vomiting、irritability、other sites of bleeding have higher incidence in infants, while shortness of breath、moaning were more common in neonatal.For signs, nerve reflex abnormalities were more common in the newborn, while the plump bregma、abnormal pupil、coma were more common in infants and young children. In neonatal group,diagnosis of neonatal asphyxia(35/67, 52.24%), prematurity(27/67, 40.30%).Analysis of abnormal perinatal factors revealed that low birth weight and fetal distress(P < 0.05, OR > 1) is the main perinatal risk factors of neonatal cerebral hemorrhage, cesarean section(P < 0.05, OR < 1) is protecting factors which reduced the risk; in infant group the main etiological diagnosis is delayed vitamin K deficiency(54/69, 78.26%), breast feeding is the major risk factors of late vitamin K deficiency in infants(P < 0.05, OR > 1).Conclusions:1.Less than 7 days 、1-3 months after birth were ages of peak incidence in nontraumatic intracranial hemorrhage of children below 2 years old。2.For clinical manifestations,symptoms and signs of intracranial hemorrhage in newborns and infants groups constitute difference 。 The following symptoms and signs had different incidence in two groups:abnormal complexion(pale,cyanosis)、vomiting、shortness of breath、groan、other sites of bleeding、irritability;dysreflexia、full bregma、abnormal pupil、coma。3.In neonatal group,common etiological diagnosis is neonatal asphyxia, premature; low birth weight, fetal distress is the main perinatal risk factors of neonatal onset, in certain extent, caesarean section can reduce the incidence of neonatal cerebral hemorrhage. Late vitamin K deficiency was common etiological diagnosis for infants, breast feeding is the mainly risk factor for deficiency of vitamin K。...