Intracerebral Hemorrhage in Neonates and Hereditary Thrombophilia
Author(s): Britta Gehrlein, Luciana Porto, Rolf L Schloesser, Doris Fischer
Hemorrhage of the central nervous system in neonates is mostly associated with risk factors like early prematurity, way of
delivery, birth trauma, vitamin K deficiency, hereditary hemophilia or acquired coagulopathy. However, in some patients the pathogenesis
of ICH remains unclear.
Patients and Methods: Cohort study of 27 term and near to term neonates with Intracerebral Hemorrhage (ICH). In the subgroup of patients
without obvious risk factors for ICH (n=20), thrombophiliac diagnostic workup was performed.
Results: 15 terms and 12 preterms (> 32 weeks GA) were examined. Way of delivery was cesarean section (n=12), assisted vaginal delivery
(ventouse delivery; n=1, forceps delivery; n=3) or spontaneous (n=11). First clinical symptoms for ICH were isolated persistent abnormal
body temperature (n=5) or seizures (n=14), or the combination of fever with seizures and/or paleness, muscular weakness and arterial
In this cohort study, known risk factors like birth asphyxia (n=4), vitamin K deficiency (n=1), hereditary haemophilia A (n=1) and traumatic
brain injury (n=1) were identified. In 2 patients chromosomal anomalies (Prader Willi Syndrome resp. Noonan Syndrome) were diagnosed.
For the remaining 18 patients; 7 cases with single or double hereditary thrombophilia (homozygous Protein S deficiency (n=1), Factor XII
deficiency (n=2), Mutation in MTHFR Gene (C677T, A1298C) (n=3), Factor V Leiden Mutation (G1691A) (n=3), Prothrombin-Mutation
(n=1) and Hyperhomocysteinaemia (n=1) were found.
Conclusion: Herein, an association between hereditary thrombophilia and neonatal ICH was found. Further investigations are necessary to
reveal the role of hereditary thrombophilia in the pathogenesis of neonatal ICH.
Will be updated soon