Birth Intracranial Trauma

Title: Birth intracranial injury

Birth intracranial injury is damage to the child’s brain during childbirth, which is based on vascular rupture and intracranial hemorrhage.

Etiology and pathogenesis

Minor hemorrhages can occur as a result of red blood cells leaking through the walls of blood vessels (diapedesis). Factors contributing to the occurrence of intracranial birth injury are: pregnancy pathology (preeclampsia, maternal illness), excessive mechanical compression of the fetal head during passage through the birth canal (narrow pelvis, fetal position abnormalities), obstetric aids.

Predisposing factors are: morphological immaturity and variations in the structure of blood vessels and the vascular wall, reduced capillary resistance, insufficient content of coagulation factors in the blood of newborns, imperfect nervous regulation of vascular tone. Severe hypoxia and acidosis also contribute to hemorrhage due to increased vascular permeability.

By localization they distinguish: epidural, subdural, subarachnoid, intra- and periventricular hemorrhages.

The clinical picture depends on the location and volume of hemorrhage. Signs of injury may appear immediately after birth or several hours/days later. There are 3 stages: depression, excitement and slow recovery.

The diagnosis is established on the basis of anamnesis, clinic, cerebrospinal fluid examination, and imaging. Differential diagnosis is carried out with malformations of the brain, encephalopathies, infections, and metabolic disorders.

Treatment: rest, dehydration, sedatives, anticonvulsants, vitamin therapy. In severe cases, surgical treatment may be required. The prognosis is serious due to high mortality and disability. Prevention: pregnancy monitoring, obstetrics.