Intracranial hemorrhage

Introduction Intracranial hemorrhage refers to the rupture of blood vessels in the brain, causing hemorrhage. Therefore, the brain cells that receive blood from the blood vessels are destroyed, and the blood vessels are forced to block the surrounding nerve tissue. Usually intracranial hemorrhage will occur in combination with hyperthermia. This symptom increases the oxygen consumption in the brain, which in turn causes insufficient oxygen supply to the brain. Intracranial hemorrhage is a common serious disease in newborns and one of the leading causes of perinatal neonatal death. Under the sacral membrane, intraventricular hemorrhage is the longest.

Cause

Intracranial hemorrhage refers to the rupture of blood vessels in the brain, causing hemorrhage. Therefore, the brain cells that receive blood from the blood vessels are destroyed, and the blood vessels are forced to block the surrounding nerve tissue.

an examination

Diagnosis of neonatal intracranial hemorrhage:

1. History: gestational age less than 32 weeks, weight less than 1500g, prone to subventricular hemorrhage and ventricular hemorrhage, the incidence rate can reach 40% to 50%. It happens more than 3 days.

2. Clinical manifestations: There is often no excitatory process, and the symptoms are obvious, such as refusal of milk, lethargy, low response, low muscle tone, and disappearance of hug reflex. Paroxysmal respiratory rhythm irregularities and apneas often occur with convulsions. There were convulsions and coma in the late stage. The complexion is pale, the front is bulging, the eyes are gazing, the pupils are not equal or loose, and the light reflection disappears.

3. Auxiliary inspection

(1) Hemoglobin, platelets, and hematocrit decrease. Prothrombin time is long, indirect bilirubin is increased, blood gas analysis is metabolic and respiratory acidosis, hypoxemia.

(2) Cerebrospinal fluid: subarachnoid and intraventricular hemorrhage, cerebrospinal fluid is bloody, microscopic examination reveals red blood cells.

(3) Others: If the changes of the bregma and head circumference are observed dynamically, cranial transillumination, skull B-ultrasound and CT examination can be detected as needed. CT can accurately understand the type, location, and degree of bleeding, and evaluate the prognosis. The specific index is: I degree: subventricular hemorrhage, II degree: ventricular hemorrhage without ventricular dilatation, above 90% survival, III: Ventricular hemorrhage with ventricular dilatation, IV filling: ventricular hemorrhage with brain parenchymal hemorrhage, the mortality rate of 50%.

Differential diagnosis

Cerebral hypoxia in intracranial hemorrhage is more common in irregular superficial or pause of breathing, while pulmonary hypoxia is mainly caused by shortness of breath, nasal discharge and tri-concavity. After oxygenation and crying, cyanosis is improved. Cardiac hypoxia often has respiratory depth. Increase, after the oxygen is blue and blue. The convulsion should be differentiated from cerebral edema, hypoglycemia, low calcium, low sodium, hypomagnesemia, vitamin B6 dependence, intracranial malformation, infection, and nuclear jaundice after asphyxia. Low muscle tone should be differentiated from congenital, myasthenia gravis, congenital muscle relax syndrome, heart or muscle glycogen accumulation disease.

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