Case of intracerebellar hemorrhage in full-term newborn infant

Abstract

A 20-day-old girl who was born in full term without perinatal problems (Apgar score 10) suddenly developed a respiratory distress with frequent episode of vomiting. On the following day, she had one attack of generalized convulsion and was admitted. Laboratory data on admission indicated normal blood counts, normal blood chemistry, and normal bleeding and coagulation times. Hepaplastin test was 55%. CT scan showed a hematoma in the posterior lobe of left cerebellar hemisphere, which was immediately evacuated without performing angiography, because the patient showed the evidence of impending tonsillar herniation. Histological examination with HE and van Gieson stainings showed no abnormality in the hematoma. Thus, no confirmation of precipitating cause could be obtained. Later, she underwent ventriculo-peritoneal shunt because of progressive hydrocephalus. Twelve months later, she showed normal physical growth and a moderate degree of mental retardation. Spontaneous intracerebellar hemorrhage was rare, particularly in a newborn after 2 weeks. Majority of such cases, previously reported, were premature babies. So far 12 cases have been reported in the literature among full-term newborns of less than 2 weeks in age.