Early vitamin K deficiency bleeding after maternal phenobarbital intake : management of massive intracranial haemorrhage by minimal surgical intervention

Vitamin K deficiency bleeding within the first 24 h of life is caused in most cases by maternal drug intake (e.g. coumarins, anticonvulsants, tuberculostatics) during pregnancy. Haemorrhage is often life-threatening and usually not prevented by vitamin K prophylaxis at birth. We report a case of sev...

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Bibliographic Details
Published in:European journal of pediatrics 1998-08, Vol.157 (8), p.663-665
Main Authors: RENZULLI, P, TUCHSCHMID, P, EICH, G, FANCONI, S, SCHWÖBEL, M. G
Format: Article
Language:English
Subjects:
Age
Anticonvulsants
Anticonvulsants - administration & dosage
Anticonvulsants - adverse effects
Babies
Biological and medical sciences
Breastfeeding & lactation
Case reports
Cesarean Section
Children & youth
Disease prevention
Epidural
Epilepsy, Generalized - drug therapy
Female
Hematoma, Subdural - chemically induced
Hematoma, Subdural - surgery
Hemorrhage
Humans
Infant, Newborn
Intensive care
Intracranial pressure
Medical imaging
Medical sciences
Neurology
Pediatrics
Phenobarbital - administration & dosage
Phenobarbital - adverse effects
Pregnancy
Pregnancy Complications - drug therapy
Surgery
Treatment Outcome
Trephining
Vascular diseases and vascular malformations of the nervous system
Vitamin K Deficiency - chemically induced
Vitamin K Deficiency - complications
Vitamin K Deficiency - surgery
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Summary:Vitamin K deficiency bleeding within the first 24 h of life is caused in most cases by maternal drug intake (e.g. coumarins, anticonvulsants, tuberculostatics) during pregnancy. Haemorrhage is often life-threatening and usually not prevented by vitamin K prophylaxis at birth. We report a case of severe intracranial bleeding at birth secondary to phenobarbital-induced vitamin K deficiency and traumatic delivery. Burr hole trepanations of the skull were performed and the subdural haematoma was evacuated. Despite the severe prognosis, the infant showed an unexpected good recovery. At the age of 3 years, neurological examinations were normal as was the EEG at the age of 9 months. CT showed close to normal intracranial structures. This case report stresses the importance of antenatal vitamin K prophylaxis and the consideration of a primary Caesarean section in maternal vitamin K deficiency states and demonstrates the successful management of massive subdural haemorrhage by a limited surgical approach.
ISSN:0340-6199
1432-1076
DOI:10.1007/s004310050907