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Neonatal Subpial Hemorrhage: Clinical Factors, Neuroimaging, and Outcomes in a Quaternary Care Children's Center
- Source :
- Pediatric Neurology. 120:52-58
- Publication Year :
- 2021
- Publisher :
- Elsevier BV, 2021.
-
Abstract
- Background Subpial hemorrhages are underrecognized, underreported, and poorly understood. The spectrum of their clinical manifestations and consequences in neonates has not been fully described. Here, we describe the demographic, clinical, and radiographic characteristics of neonates with subpial hemorrhages. Methods We reviewed the medical records and neuroimaging studies of neonates with subpial hemorrhage who were admitted to our neonatal intensive care unit between September 2009 and December 2020. Results Of 114 neonates with intracranial hemorrhage, 31 (27%) had subpial hemorrhage. The majority of neonates in our cohort were male (68%) and born at term (55%). The most common imaging indication was apneas and/or seizures in 58%. Common comorbid conditions included cardiorespiratory failure (42%), hypoxic-ischemic encephalopathy (26%), and coagulopathy (23%). Subpial hemorrhages were multifocal in 45% of neonates, located in the temporal lobe in 45% of neonates, and tended to be larger in neonates with coagulopathy, birth trauma, or hydrocephalus requiring neurosurgical intervention. Subpial hemorrhage was associated with another type of intracranial bleed in 77% of cases and with arterial ischemic stroke in 16% of cases. Of 17 patients with more than one year of follow-up data, 14 (82%) have developmental delay and four (24%) have epilepsy. Of 14 patients with follow-up imaging, 10 (71%) had encephalomalacia subjacent to the subpial hemorrhage. Conclusions This is the largest cohort of neonates with subpial hemorrhages to date. Outcome data are limited by duration of follow-up and may be confounded by comorbid conditions and other concurrent hemorrhages. Further study is needed to define the spectrum of risk factors and expected neurological outcomes.
- Subjects :
- Male
Pediatrics
medicine.medical_specialty
Neonatal intensive care unit
Birth trauma
Developmental Disabilities
Encephalopathy
Infant, Newborn, Diseases
Tertiary Care Centers
03 medical and health sciences
Epilepsy
0302 clinical medicine
Developmental Neuroscience
Intensive Care Units, Neonatal
030225 pediatrics
Outcome Assessment, Health Care
medicine
Coagulopathy
Humans
Encephalomalacia
Neonatal stroke
Cerebral Hemorrhage
Retrospective Studies
business.industry
Infant, Newborn
Hospitals, Pediatric
medicine.disease
Hydrocephalus
Neurology
Pediatrics, Perinatology and Child Health
Pia Mater
Female
Neurology (clinical)
business
030217 neurology & neurosurgery
Follow-Up Studies
Subjects
Details
- ISSN :
- 08878994
- Volume :
- 120
- Database :
- OpenAIRE
- Journal :
- Pediatric Neurology
- Accession number :
- edsair.doi.dedup.....c30802165ac9c35d34a1231f300de0be