This week we had 2 babies who have received 1 mg of vit.k in the neonatal period presenting with intracranial bleed.

baby.1; 39 days old, B/o V mother anemic undernourished. Baby on exclusive breastfeeds.Baby had fever due to mastitis(skin laceration due to hook injury). Developed focal fits on LT side . Both PT & aPTT prolonged.platelets normal.CT shows bleed on RT side

needed 2 anticonvulsants to control convulsions.

Had blood transfusion for low Hb{8gms%}.

Now baby is better. Feeding well.

Any clues for the reason for the Intracranial bleed? Eventhough the baby received vit.K?

selvan rathinasamy

Erode, India

One year ago we treated baby second from twins weighted 420 g. His IVG began in 1.5 month of age, and it was first sign of CMV infection.

How sick was the baby prior to bleed?

Did u evalutae for markers of DIVC?

Any significant family history? One need to rule out inherited abnormalities of coag system esp involving common pathways

Two useful links

http://www.ncbi.nlm.nih.gov/pubmed/18625545

http://www.ncbi.nlm.nih.gov/pubmed/11949019

Investigate primary dysfunctions of coagulation (coagulation factors etc) and secondary causes like infections, as suggested by Alex above.

And please do not forget: although intracranial bleedings are usually spontaneous events, some infants have injuries as a result of trauma/abuse. Check for other signs of shaken-baby syndrome (such as retinal bleeds) if localization of cerebral bleeds indicate trauma.

the baby has responded well. convulsions controlled and discharged

Are they delivered in an institution like yours

Some time preparations make lot of difference

Some authors suggest you can go upto 5 mg

Did you check D-dimor ? Any long term antibiotics?

Very crucial situations is altered perfusion states we need to monitor BP preferably invasive??