Journal of Developmental Medicine(Electronic Version) 2020, Vol. 8 Issue (2): 173-177 DOI: 10.3969/j.issn.2095-5340.2020.02.015 |
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Neurosurgical management and follow-up for intracranial hemorrhage in term neonates |
Yan Xiaodan, Li Bingxiao, Han Shasha, et al
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Neonatology Department, The First Affiliated Hospital of Ji'nan University, Guangdong, Guangzhou 510000, China |
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Abstract 【Abstract】 Objective To explore the high-risk factors, clinical manifestations, surgical efficacy and prognosis of intracranial hemorrhage in newborns to improve cognition and early diagnosis and treatment. Methods From June 2012 to July 2014, in the admitted full-term newborns who were diagnosed as neonatalintracranial hemorrhage (NICH) in The First Affiliated Hospital of Ji'nan University, four cases received surgical treatment and regular follow-up until preschool. The perinatal situation, clinical manifestation, laboratory examination, surgical treatment and prognosis of the four cases were analyzed retrospectively.
Results The four cases all had perinatal high-risk factors (abnormal umbilical cord, decreased fetalheart rate, cephalopelvic disproportion, cesarean section due to failure of vaginal delivery, amniotic fluidcontamination, etc.). The first symptom was not nervous system abnormality in the four cases. In brainultrasonography, they all showed positive findings. The type and amount of intracranial hemorrhage werefurther confirmed by CT. Case 1: bilateral lateral ventricles and third ventricles were widened. Case 2:subdural hematoma and subdural hemorrhage, and cranial displacement. Case 3: extradural hematoma. Case4: intracerebral hemorrhage combined with cerebral hernia. Three cases underwent emergency treatment andgot removal of hematoma by craniotomy. Case 1 had conservative treatment for three days, then accepted thelateral ventricle drainage. Four children were followed up after discharge until preschool, and they all hadsatisfactory prognosis. Conclusions The NICH of full-term newborns may be related to perinatal factors.The early clinical manifestations lack specificity. Early head ultrasound screening and CT diagnosis arerecommended, and timely surgical treatment can improve the prognosis.
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Received: 25 September 2019
Published: 23 April 2020
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