When a brain haemorrhage in newborns may be a consequence of cerebral palsy - Cerebral Palsy. This severe birth trauma appears in violation of the integrity of the blood vessels, which is why under the lining of the brain accumulates blood. May cause irreversible changes in the central nervous system. Early detection of problems and treatment help restore the state and reduce the risk of developing pathology.
Causes
The causes of bleeding in the brain of a newborn can be linked to external effects such as obstetric error or unwillingness the mother to follow the doctor's orders, a violation of the physiological development of the fetus and internal abnormalities, prematurity and Prolonged.
Factors causing cerebral hemorrhage:
- Complicated pregnancy and childbirth occurring complications - hypoxia, anhydrous prolonged period.
- Actions obstetrician. For example, forceps or pneumatic cups may be accompanied by cranial trauma.
- Pregnancy, post-term by more than 10 days. The elasticity of the skull bone is reduced, and the passage through the birth canal can cause vascular injury.
- Intrauterine infection. Pathology may be accompanied by heart disease, a common violation of physiological development.
Children with prematurity at a weight of 1.5 to 2 kg probability cerebral hemorrhage is 50-55%, at birth weight of less than 1 kg - 99-100%.
Types and degrees
Infant pathology is characterized by a relatively accepted parameters. WHO has established 3 degrees violations in Russia to differentiate 4 degrees. The first time the ventricles are not injured, bleeding is localized in the walls. When the blood enters the second cavity, the third - it extends from the ventricles of the surrounding tissue. When the fourth degree affected all ventricles and brain matter.
epidural
This type of disease causing rapid labor, prolonged pregnancy with the expectation of self-labor, hypoplasia of the skull bones in utero. The vessels are damaged between the dura and the skull. Symptoms occur within 72 hours after birth.
subdural
In 95% of cases appear in separate delivery if the baby's head does not match the size of the maternal pelvis. Are detected immediately by the absence of the necessary reflexes and appearance of seizures. In such brain damage in newborns blood accumulates between soft and hard brain membranes.
subarachnoid
The probability of occurrence increases with the imposition of obstetrical instruments or personnel error. The blood accumulates in the tissues and membranes under the brain membrane.
Parenchymal and intraventricular
It appears in the pathological course of pregnancy, intrauterine infection, prematurity. Blood can accumulate in both ventricles simultaneously or only one, as well as connective tissue.
Symptoms and signs
Can detect abnormalities at birth, within a few hours or even days. Diagnosis is by characteristic symptoms in children with laboratory hardware and surveys.
Symptoms of cerebral hemorrhage depends on the type of hemorrhage:
- When epidural - heavy breathing, slow heart rate, pupil from the damaged side is expanded.
- Subdural causes muscle weakness, unconditioned reflexes are absent in infants having seizures, repetitive cycles. Stop without using pharmaceuticals difficult.
- Subarachnoid accompanied by hyperactivity, irritability, disturbance of sleep, frequent monotonous cry. Possible strabismus.
- Ventricular and interventricular can lead to sleep apnea - stopping breathing.
Common symptoms, which in infants can suspect the presence of diseases, - a frequent regurgitation fountain, or weakness hyperexcitability, developmental delays, headaches, which indicates a groan on one note, and attempts to reach out hands to forehead. You should alert periodic breath, numbness with increase paleness of the skin, the sharp drop in temperature, no sucking reflex, appetite disorders. On the accumulation of blood in the brain tissue suggest a paresis of the limbs and stiff neck muscles.
Diagnosis newborn spend in the hospital. To assess the state make general and specific blood tests - always coagulation, a puncture - to conduct analysis of the cerebrospinal fluid and cerebral fluid for the presence of blood fragments. It may take x-rays of the skull, neurosonography, MRI or CT scan. If abnormality is detected later, it indicates changes in behavior, in this case it is possible outpatient surveys.
Treatment
If the condition is severe, large hematoma, resuscitation carried out already in the delivery room. Possible resuscitation - bypass surgery, puncture or external drainage, implantation of ventricular catheter under the skin, drip with blood thinners. You may need urgent surgical intervention, surgery is performed neurosurgeons. Therapeutic scheme determined based on the clinical picture. In asymptomatic recommended conservative treatment.
To prevent severe complications remove excess fluid from the affected tissues of the above described methods or use of diuretics. It helps to normalize intracranial pressure and eliminates the swelling of the brain. It may require transfusions of blood or plasma, the introduction of anticonvulsant drugs and hormones. To prevent secondary infection prescribe antibiotics.
The efficiency of trometamol. Introduction drug suppresses inflammation and normalizes daily diuresis, eliminating cerebral edema. For relief of cramps use of beta-blockers, benzodiazepine tranquillizers, magnesium sulfate injection solution. As auxiliary agents used B vitamins and sedatives. The dosage and frequency of administration was calculated for each patient individually.
Forecasts and complications
When grade 3-4 defeat survival rate is 1-1.5%. The child remains disabled for life, irreversible changes in the brain. The consequences of a brain hemorrhage in infants above 2 depend on the localization of the hematoma. The most common complications are paresis, paralysis and hydrocephalus. Against the background of paresis in infants Seizures and convulsions may appear - up to 20 a day.
The consequences of hydrocephalus include neuropsychiatric patologii- cerebral palsy, post-traumatic epilepsy, dementia. The baby becomes restless, because of severe headaches changing behavioral responses. Disturbed locomotor activity, reduced intelligence. If grade 3 injury to the child if he was able to survive until adulthood, it is impossible to inoculate domestic skills, he can not move himself.
If the hematoma is small, the degree of bleeding at most 2 children survive, but behavioral characteristics accompany them to transition to adolescence. They have heightened anxiety, have difficulty getting to sleep, decreased appetite. Such children need special attention, supplement the diet with vitamin-mineral complexes, therapeutic exercise. In this case, by 10-12 years may neutralize the effects of birth trauma.
newborn brain has a higher adaptive capacity, and timely diagnoses for the consequences of hemorrhage manages to neutralize. After discharge from the hospital the baby put on the account to a pediatric neurologist, recommend regular massage, physiotherapy and spa treatment. Parents are warned about the duration of the recovery process.