Intracranial hemorrhage in the newborn

Abstract

Intracranial hemorrhage is now the most important neurologic problem encountered in the newborn. Of the 4 major varieties of neonatal intracranial hemorrhage, periventricular hemorrhage has assumed the dominant position in frequency and clinical significance and is the focus of this discussion. [Neuropathology, pathogenesis and management are discussed.] The other 3 types, reviewed elsewhere, are subdural, primary subarachnoid and intracerebellar hemorrhage. The therapeutic approach is to institute daily lumbar punctures from the time of diagnosis of the hemorrhage. If ventricular dilation appears and progresses despite lumbar punctures, glycerol is used to control the hydrocephalus. If ventricular dilation continues to progress, a ventriculoperitoneal shunt is installed.