CT DEMONSTRATION OF INTRACRANIAL BLEEDING IN TERM NEWBORNS WITH MILD CLINICAL SYMPTOMS

This paper presents symptomatic term newborns with negative ultrasound examination which showed intracranial bleeding demonstrated by CT sca n, Fifty-eight term newborns with Apgars of 9-10 were referred for rep eat CT examination of the brain with symptoms, such as apnea, disturba nces of swallowing or sucking, impaired muscular tonus, tremor and jer ks, The ultrasound examination in all was normal. The first CT scan wa s performed 12-13 h after delivery, The second CT scan was performed a t least two weeks later, Twenty-three of the patients underwent lumbar puncture, Physical examination was performed on each patient at birth and one week later, The clinical symptoms were still present at the t ime of the second physical examination. Fourteen to seventeen months f ollowing the delivery, the psychomotor development was evaluated in 29 of the children using the Gesell test, In five children, the diagnosi s of psychomotor retardation was established which correlated with the brain atrophy demonstrated on CT. Twenty-three newborns who underwent lumbar puncture showed evidence of bleeding into the subarachnoid spa ce, The blood haemoglobin levels of all the cases was below 18 g/dl. T he first CT examination demonstrated blood in the subarachnoid space, The second CT scan did not demonstrate any findings. Intracranial blee ding in newborns may be associated with normal delivery, The demonstra tion of high densities in the first CT scan, the normal second CT scan , the blood tinged or xantochromic CSF and the normal blood haemoglobi n levels are indicative of intracranial bleeding.