Intracranial hemorrhages are another term for bleeding that occurs inside the brain or skull. While they can range between very mild to severe, they must be quickly diagnosed in order to properly initiate treatment. They are also related to extracranial hemorrhages, which refer to bleeding that occurs in the tissues outside the skull.
Types of Intracranial Hemorrhages
Brain bleeds are classified differently depending on the location where the bleeding is occurring. The location and extent of the bleeding determine what kind of damage the bleeding will cause.
Bleeding within the brain itself; classified as a type of stroke caused by a ruptured blood vessel.
Bleeding between the brain and the inner membrane that covers it. This is the second most common brain bleed in full-term babies and can cause seizures, breathing issues and lethargy. This serious bleeding is linked to hydrocephalus, PVL, cerebral palsy and brain damage.
The most serious type of brain bleed where blood is forced into the brain’s ventricles, where spinal fluid is produced. It is most common in premature and low-birthweight infants.
Subdural Hemorrhage and Hematoma
The most common brain bleed in babies where blood collects on the brain’s surface. This bleeding causes seizures, jaundice (high bilirubin levels), a head that grows too fast, poor Moro reflexes and retinal bleeding.
Cephalohematomas (or cephalhematomas) are bleeding outside the baby’s skull. These are usually not severe and show up as raised bumps on the baby’s head. These typically go away on their own, but can lead to infections or calcifications if they require treatment and are left untreated.n lead to infections or calcifications if they require treatment and are left untreated.
Signs, Diagnosis and Treatment of Intracranial Hemorrhages
The symptoms of a brain bleed can vary, but they overlap with the symptoms of HIE. These symptoms can include lethargy, seizures, apnea and breathing issues, feeding issues, bulging soft spots on the baby’s head, the baby being too floppy or tense, and issues with staying conscious.
Brain imaging is absolutely critical for diagnosing an intracranial hemorrhage. If medical staff suspect that the baby had a brain bleed, they should be doing head imaging studies using a CT scan or MRI. They can also do ultrasound tests and tests of cerebrospinal fluid as well.
Unfortunately, treatment for intracranial hemorrhages tends to be supportive (though surgery might be necessary for relieving pressure in some cases). Some babies with brain bleeds recover very well, while those with severe bleeding (and resulting hypoxic-ischemic encephalopathy) may have intellectual or developmental disabilities and/or cerebral palsy.