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Intracranial haemorrhage: an incidental finding at magnetic resonance imaging in a cohort of late preterm and term infants

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Abstract

Background

Intracranial haemorrhage (ICH) in term newborns has been increasingly recognised but the occurrence in late preterm infants and the clinical presentation are still unclear.

Objective

To investigate the appearance of intracranial haemorrhage at MRI in a cohort of infants born at 34 weeks’ gestation or more and to correlate MRI findings with neonatal symptoms.

Materials and methods

We retrospectively reviewed neonatal brain MRI scans performed during a 3-year period. We included neonates ≥34 weeks’ gestation with intracranial haemorrhage and compared findings with those in babies without intracranial haemorrhage. Babies were classified into three groups according to haemorrhage location: (1) infratentorial, (2) infra- and supratentorial, (3) infra- and supratentorial + parenchymal involvement.

Results

Intracranial haemorrhage was observed in 36/240 babies (15%). All of these 36 had subdural haemorrhage. Sixteen babies were included in group 1; 16 in group 2; 4 in group 3. All infants in groups 1 and 2 were asymptomatic except one who was affected by intraventricular haemorrhage grade 3. Among the infants in group 3, who had intracranial haemorrhage with parenchymal involvement, three of the four (75%) presented with acute neurological symptoms. Uncomplicated spontaneous vaginal delivery was reported in 20/36 neonates (56%), vacuum extraction in 4 (11%) and caesarean section in 12 (33%). Babies with intracranial haemorrhage had significantly higher gestational age (38 ± 2 weeks vs. 37 ± 2 weeks) and birth weight (3,097 ± 485 g vs. 2,803 ± 741 g) compared to babies without intracranial haemorrhage and were more likely to be delivered vaginally than by caesarian section.

Conclusion

Mild intracranial haemorrhage (groups 1 and 2) is relatively common in late preterm and term infants, although it mostly represents an incidental finding in clinically asymptomatic babies; early neurological symptoms appear to be related to parenchymal involvement.

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Acknowledgments

The authors thank all the nurses, obstetricians and paediatricians who collaborated on this study.

Conflicts of interest

None.

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Authors and Affiliations

  1. Neonatal Intensive Care Unit, Department of Clinical Science and Community Health, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Universita degli Studi di Milano, via della Commenda 12, 20123, Milan, Italy

    Ida Sirgiovanni, Michela Groppo, Laura Bassi, Sofia Passera, Paola Schiavolin, Monica Fumagalli & Fabio Mosca

  2. Department of Neuroradiology, Fondazione IRCCS Ca’Granda Ospedale Maggiore Policlinico, Universita degli Studi di Milano, Milan, Italy

    Sabrina Avignone, Claudia Cinnante & Fabio Triulzi

  3. Neonatal Intensive Care Unit, V. Buzzi Children’s Hospital, ICP, Milan, Italy

    Gianluca Lista

Authors
  1. Ida Sirgiovanni
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  2. Sabrina Avignone
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  3. Michela Groppo
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  4. Laura Bassi
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  5. Sofia Passera
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  6. Paola Schiavolin
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  7. Gianluca Lista
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  8. Claudia Cinnante
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  9. Fabio Triulzi
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  10. Monica Fumagalli
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  11. Fabio Mosca
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Corresponding author

Correspondence to Ida Sirgiovanni.

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Sirgiovanni, I., Avignone, S., Groppo, M. et al. Intracranial haemorrhage: an incidental finding at magnetic resonance imaging in a cohort of late preterm and term infants. Pediatr Radiol 44, 289–296 (2014). https://doi.org/10.1007/s00247-013-2826-7

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  • DOI: https://doi.org/10.1007/s00247-013-2826-7

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