Intracranial Hemorrhage (IVH) and Cerebral Palsy

intracranial hemorrhageHemorrhages in the brain are always dangerous and require immediate medical attention. However, when they happen to an infant before, during or not long after birth, the consequences can be far more severe. In fact, there are a few areas of the brain that are essential to motor skills and overall development that can actually become impaired. Intracranial hemorrhages are those that injure the brain in this way and come in four different grades based on their severity. There are two different kinds of intracranial hemorrhaging:

  • Venous Bleeding: wherein the veins in charge of returning blood to the heart suffer a hemorrhage.
  • Arterial Bleeding: wherein the tissues that carry blood to the heart suffer a loss of oxygen.

Intracranial Hemorrhage Grades

There are four grades of intracranial hemorrhages that are important to know. The first two, Grade I and Grade II, are usually characterized by small amounts of bleeding in the ventricles. Neither of these grades pose much of a long-term threat and infants will heal from these hemorrhages on their own.

However, Grades III and IV are marked by excessive bleeding. As a result, they can both obstruct normal operations in the brain and even cause swelling. If either of these conditions becomes too severe, the child could suffer from hydrocephalus. This would increase the pressure in the brain until surgery became necessary to save it. Unfortunately, this pressure could also give a child cerebral palsy.

Intracranial Hemorrhage Causes

The most common risk factor associated with intracranial hemorrhages is premature birth. However, there are a number of other risks that you should know about as they may contribute to a serious injury:

  • Blood clots in the placenta
  • Infant stroke
  • Asphyxiation
  • Maternal hypertension
  • Maternal infection
  • Pelvic inflammatory disease
  • Trauma from prolonged labor
  • Traumatic head injuries
  • Underdeveloped or malformed blood vessels in the brain
  • Medical malpractice during the delivery (e.g. improper use of tools, applying excessive pressure to the infant, etc.)
  • Macrosomia

Again, while premature birth is the most common cause, the ones above should give you reason for concern as well.

Signs and Symptoms of Intracranial Hemorrhage

An infant that exhibits an extreme degree of lethargy is displaying one of the initial and most noticeable signs of intracranial hemorrhage. The infant may be constantly tired or simply unresponsive because of their exhaustion. There are other warning signs to look out for, though, including:

  • Weak musculature
  • Pale or bluish skin
  • Poor or weak reflexes
  • A drop in blood count
  • Seizures
  • Difficulty sucking
  • Bleeding of the retina
  • Elevated levels of bilirubin

Should any of these symptoms arise; physicians will most likely perform tests to assess if the infant has a brain injury. Generally, this means running them through a CT scan or an MRI to see if there is blood in the skull.

Sometimes, physicians may conduct an ultrasonography as well and then continue with ultrasounds if they notice anything amiss. Fortunately, if the bleeding is relatively minor, the problem will heal on its own in most cases.

However, like we stated above, Grades III and IV of intracranial hemorrhages pose a number of health risks. If a child is suffering from one of those, they will definitely need to undergo neurosurgery.

Intracranial Hemorrhage Prognosis

Aside from cerebral palsy, cognitive and intellectual disabilities could result from intracranial hemorrhages too. However, there is no way to generalize the prognosis because it depends so highly on the individual and the type of injury involved. Some will never be affected by it while others will suffer permanently from various disorders.

To be on the safe side, always be sure to check with a doctor if you believe your infant may have suffered a serious injury to their head.

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