604 Large Focal Cerebral Haematomas: Neonatal Presentation and Outcome

Abstract

Background and aims: To evaluate perinatal factors and outcome in term neonates with large focal cerebral haematomas. Methods: All term neonates seen between 1994-2009 with a neonatal brain MRI and large focal haematomas were included. Lesions were classified by site. Perinatal data and sequential neurodevelopmental outcome at 2,4,>5yrs (neurological exam, Griffiths scales/WPPSI, Movement ABC) were available. Results: 32 infants were studied: Haematomas were frontal(F) in 10, temporal(T) in 8, parietal(P) in 8, cerebellar(C) in 3 and in deep grey matter (DGM) in 3. Mean GA was 40.1 week, mean birthweight 3.33 kg, median 1,5 min Apgar scores were 7.5 and 9. Eight required major resuscitation at birth. Eight presentation with seizures alone, 14 seizures+other symptoms, 2 HIE (no seizures),1 postnatal collapse, 3 full fontanelle, 4 apnoeas/ bradycardiasOutcome: 1 infant died (HIE), 8 are 5yrs: n=13; 9 normal FSIQ(WPPSI) including 3 with abnormal MABC (2F,1DGM); 1 child was autistic (normal range DQ at 4yrs, F) two mild/moderate delay (1C,1DGM), one severely delayed (DGM). One child had febrile seizures and two had lateonset epilepsy. Conclusions: At each assessment age about 1/3 of children had developmental problems, some were severely affected, mostly those with cerebellar or DGM lesions (without CP). In the majority of children with isolated hemispheric haematomas outcome was consistently good.