The Clinical Analysis Of Seventy-eight Cases Of Spontaneous Intracranial Hemorrhage In Infants

Objective: To investigate the clinical feature of spontaneous intracranial hemorrhage(SICH) in infants.Methods: Clinical data of 78 cases of spontaneous intracranial h emorrhage in infants(age≤3 yr) at Children`s Hospital of CQMU from January.2011 to December.2015 were collected. And the research is presented by a retrospective study of pathogeny, radiography, complications and outcomes.Results:1.Counting of all cases is 78 totally which accounting for 41.94% of total SICH patients over the same period. The age ranges from 14 days to 3 years old, and average age comes to 0.49 yr. The illness duration shifting from 8 hours to 15 days averages 3.45 days.2.Main clinical manifestations include high intracranial pressure symptoms(74.4%), disturbance of consciousness(56.4%), hemiplegia(15.4%), jaundice(11.5%), et al.3. Pathogenesis we found contributing to SICH: 61 cases(78.2%) of Coagulation disorder, including45 cases(57.8%) of delayed vitamin-K deficiency, 8 cases(10.3%) of hemophilia, 1 case(1.3%) ofhemophagocyt ic syndrome, 1 case(1.3%) of acute leukemia and 3 cases(3.8%) of coa gulation disorder for unknown reasons; 13 cases(16.7%) of cerebro- vascular-malformation, including 10 cases(12.8%) of arterio-venous- malformation(AVM), 2 cases(2.6%) of arterial aneurysm and 1 case(1.3%) of capillary angioma; 2 cases(2.6%) of hypoxic ischemic encephalo pathy(HIE); 2 cases(2.6%) of cerebral paragonimiasis.4.Each of the patients got the definite diagnosis by a CT/MRI(plain scan) examine, and the hemorrhage positions were like this: Intracerebral hematoma(ICH) 47 cases(60.3%), subarachnoid hemorrhage(SAH) 41 cases(52.6%), Subdural hemorrhage(SDH) 38 cases(48.7%), intraventricular hemorrhage(IVH) 19 cases(24.4%).5. 19 cases with suspected cerebrovascular malformation were arranged to take a CT- angiography(CTA) inspection, strengthen CT/MRI scan,and 13 cases turned out to be positive,which including 10 cases(12.8%) of arteriovenousmalformation(AVM), 2 cases(2.6%) of arterial aneurysm and 1 case(1.3%) of capillary angioma,therefore the detection rate is 68.9%, and lately surgeries confirmed the precision rate is 100%,3 cases turned out to be positive in strengthen CT/MRI scan.6.We also figured out the statistics of complications: Seizure 55cases(70.5%) including single seizure 11 cases(14.1%), secondary epilepsy 43 cases(55.1%) and epilepsy persistent state 1 case(1.3%); Anemia 32 cases(41.0%) including mild anemia 16 cases(20.5%) and severe anemia 16cases(20.5%); cerebral infarction 10 cases(12.8%); hydrocephalus 14 cases(17.9%); extensive encephaledema 15 cases(19.2%); cerebral hernia 20cases(25.6%); respiratory failure 8 cases(10.3%); Especially, we found 11 cases(14.1%) of immune suppression, and 29 cases of infections of kinds(high up to 37.2%).7.At the time of discharge from hospital, it turned out that 20 cases of fine outcome, 35 cases of slight disability, 20 case of severe disability, 2 cases of vegetative state, 1 case of death.Conclusions: Spontaneous intracranial hemorrhage(SICH) in infants has higher incidence,the main pathogenesis contributing to SICH of infants is coagulation disorder, cerebro-vascular-malformation(from high to low); the high detection rate and precision of CTA which is untraumatic and safe prove the worth in clinical application; among all those complications mentioned, cerebral hernia and respiratory failure have the remarkable influence to worse outcome; the SICH of infants may lead to immune suppression which has intimate connection with another important complication,namely infections; Outcomes turned pretty good after positive cure.