Vitamin K deficiency — Late onset intracranial haemorrhage

• Published in: European journal of paediatric neurology 1998, Vol.2 (4), p.199-203
• Main Authors: Aydinli, Nur, Çtak, Agop, Çalişkan, Mne, Karaböcüolu, Metn, Baysal, Serpil, Özmen, Meral
• Format: Article
• Language: English
• Subjects: Follow-Up Studies; Humans; Infant; Intracranial haemorrhage; Intracranial Hemorrhages - diagnosis; Intracranial Hemorrhages - etiology; Intracranial Hemorrhages - prevention & control; Late haemorrhagic disease of the newborn; Retrospective Studies; Tomography, X-Ray Computed; Vitamin K - therapeutic use; Vitamin K Deficiency - complications
• ISSN: 1090-3798; 1532-2130
• DOI: 10.1016/S1090-3798(98)80020-2

A retrospective study is presented of the clinical features and outcome of late onset haemorrhagic disease due to vitamin K deficiency in 11 babies who were admitted to the emergency or child neurology unit during a 4-year period (January 1994–December 1997). The disease occurred in infants between 30 and 119 days of age (mean: 56 ± 24 days). None of them received vitamin K after birth and all were breastfed. The presenting complaints were seizures (91%), drowsiness (82%), poor sucking (64%), vomiting (46%), fever (46%), pallor (46%), acute diarrhoea (27%), irritability and high-pitched cry (18%). On examination, tense or bulging fontanelle (73%), anisocoria (36%), weak neonatal reflexes (18%), cyanoses (18%) were the most frequent findings. The localizations of the intracranial haemorrhage were as follows: intracerebral (91%), subarachnoid (46%), subdural (27%), and intraventricular (27%). No fatality was observed. However, after a follow-up period ranging from 6 to 48 months (mean: 21 ± 13 months), only three (27%) infants remained neurologically normal. Seizure disorders (73%), severe psychomotor retardation (46%), cerebral palsy (46%) and microcephaly (46%) were observed in the remainder. Hydrocephalus developed in three (27%) babies but none of them required shunt replacement. The value is emphasized of vitamin K prophylaxis in the newborn to reduce the incidence of late onset intracranial haemorrhage and handicap in children.