EARLY VITAMIN-K DEFICIENCY BLEEDING AFTER MATERNAL PHENOBARBITAL INTAKE - MANAGEMENT OF MASSIVE INTRACRANIAL HEMORRHAGE BY MINIMAL SURGICALINTERVENTION

Vitamin K deficiency bleeding within the first 24 h of life is caused in most cases by maternal drug intake (e.g. coumarins, anticonvulsants , tuberculostatics) during pregnancy. Haemorrhage is often life-threat ening and usually not prevented by vitamin K prophylaxis at birth. We report a case of severe intracranial bleeding at birth secondary to ph enobarbital-induced vitamin K deficiency and traumatic delivery. Burr hole trepanations of the skull were performed and the subdural haemato ma was evacuated. Despite the severe prognosis, the infant showed an u nexpected good recovery. At the age of 3 years, neurological examinati ons were normal as was the EEG at the age of 9 months. CT showed close to normal intracranial structures. Conclusion This case report stress es the importance of antenatal vitamin K prophylaxis and the considera tion of a primary Caesarean section in maternal vitamin K deficiency s tates and demonstrates the successful management of massive subdural h aemorrhage by a limited surgical approach.