الفهرس 
Introduction and aim of the work
IntroductionOnly 14 pages are availabe for public view
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Abstract
Intracranial hemorrhage in the neonatal period is an important clinical problem . Its importance relates to a relatively high frequency of occurrence , accompanied at times by serious neurological sequelae . Intracranial hemorrhage is the pathologic accumulation of blood within the cranial vault . The condition can be categorized according to the site of origin of the hemorrhage Our study was performed in Assiut University Children Hospital – Neonatal intensive care unit , during the period from April 2017 to October 2018 . It included 150 newborns suspected to have intracranial hemorrhage . Only 50 newborns ( 33.3% ) of the total number of screened group of suspected intracranial hemorrhage , were diagnosed to have intracranial hemorrhage . 32 newborns ( 64% ) were males while 18 ( 36% ) were females , 13 ( 26% ) were full-term while 37 ( 74% ) were preterm , 14 ( 28% ) were delivered by normal vaginal delivery ( NVD ) while 36 ( 72% ) by caesarean section ( CS ) . General neonatal examination was done including : vital signs recording , anthropometric measures and full neurological examination. The most common symptoms in our patients with intracranial hemorrhage , were : poor suckling in 76% of newborns , convulsions in 36% , poor neonatal reflexes in 72 % , bulging anterior fontanelle in 18 % and decreased conscious level in 96 % . Investigations that done were Complete Blood Count , Coagulation profile , Trans-cranial sonography , CT brain and EEG . Follow-up of these cases was done at age of 3month and 6 month old by : anthropometric measures , Trans-cranial sonography , CT brain and EEG . Trans-cranial sonography at birth detected 12 cases (24% ) with intracerebral hemorrhage and 38 cases ( 76% ) with intra-ventricular hemorrhage ( IVH ) . Follow-up at 3 month of age showed : 8 cases ( 16% ) still having intra-cerebral hemorrhage , 34 cases ( 68% ) had IVH , 5 cases ( 10% ) had hydrocephalus and 3 cases ( 6% ) had subdural hematoma . Follow-up at 6 month of age showed : 4 cases ( 8% ) still having intra-cerebral hemorrhage , 32 cases ( 64% ) had IVH , 2 cases ( 4% ) had hydrocephalus and 3 cases ( 6% ) had subdural hematoma . CT brain at birth detected 6 cases ( 12% ) with hydrocephalus , 20 cases ( 40% ) with IVH , 12 cases ( 24% ) with intra-cerebral hemorrhage and 12 cases ( 24% ) with subdural hematoma . Follow-up at 3 month of age showed : 5 cases ( 10% ) still with hydrocephalus while 1case ( 2% ) improved , 16 cases ( 32% ) still with IVH while 4 cases ( 8%) improved , 7 cases ( 14% ) still with intra-cerebral hemorrhage while 5 cases ( 10% ) improved and 9 cases ( 18% ) still with subdural hematoma while 3 cases ( 6% ) improved . Follow-up at 6 month of age showed : 2 cases ( 4% ) still had hydrocephalus while 1 case ( 2% ) improved and 3 cases ( 6% ) died , 14 cases ( 28% ) had IVH while 4 cases ( 8% ) improved and 2 cases ( 4% ) died , 3 cases with intra-cerebral hemorrhage while 5 cases ( 10 % ) improved and 4 cases ( 8 % ) died and 9 cases still with subdural hematoma while 3 cases ( 6 % ) improved . EEG at birth was normal in 20 cases ( 40% ) while , it showed diffuse encephalopathy in 30 cases ( 60 % ) . Follow-up at 3 month of age revealed 20 cases ( 40 % ) of normal EEG findings while 30 cases ( 60 % ) with diffuse encephalopathy . Follow-up at 6 month of age revealed 20 cases ( 40% ) were of normal findings while 21 cases ( 42% ) with diffuse encephalopathy and 9 cases (18%) died . Mortality rate was 9 cases ( 18% ) out of diseased cases with ICH . 7 cases ( 78% ) were males while 2 cases ( 22% ) were females , 3 cases ( 33% ) were full-term while 6 cases ( 67% ) were preterm and 2 cases ( 22% ) were delivered by NVD while 7 cases ( 78% ) were delivered by CS . 3 cases ( 6% ) died with hydrocephalus , 2 cases (4%) died with intra-ventricular hemorrhage , 4 cases(8%) died with intra-cerebral hemorrhage