Spontaneous intracranial hemorrhage in children

July 2007
Journal of Pediatric Neurosciences;Jul-Dec2007, Vol. 2 Issue 2, p97
Academic Journal
AIM: Spontaneous intracranial hemorrhage in children is relatively less common as compared to adults. However clinical studies of spontaneous intracerebral hemorrhage in children have been infrequently reported. In this study, we analyze etiology, clinical features, treatment options and outcome assessment in this group of population. MATERIALS AND METHODS: 30 consecutive patients of spontaneous intracerebral bleed age 18 years and below were retrospectively analyzed. Clinical analysis was performed based on medical records and radiographic images. Age, sex, symptoms at admission, type of intracranial hemorrhage shown in the CT, cause of hemorrhage, therapeutic modalities and the outcome were examined. Status of the patient at the final follow up after discharge was considered as the outcome. RESULTS: Age of patients ranged from 2 months to 17 years. The incidence of spontaneous intracerebral hemorrhage was higher in males. Presenting features at admission were deterioration in sensorium, symptoms of raised intracranial pressure such as headache, nausea, or vomiting, hemiparesis and seizures. Arteriovenous malformation was the most common cause of hemorrhage followed by cerebral aneurysm, MoyaMoya disease, tumour, hematologic disorders and unknown causes ( ? vasculitis). Treatment modalities consisted of craniotomy for excision of AVM, aneurysm clipping, embolization, STA MCA Bypass, tumour excision, hematoma evacuation and conservative management. CONCLUSIONS: Spontaneous intracranial hemorrhage in children resulted mainly from vascular malformation and prognosis is relatively good. Overall outcome of pediatric patients was much better than that of adult patients.


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