1043-3155 Pediatr Neurol Briefs pedneurbriefs Pediatr Neurol Briefs Pediatric Neurology Briefs Pediatr Neurol Briefs 2166-6482 1043-3155 2166-3155 Pediatric Neurology Briefs Publishers Chicago, IL, USA PNB-8-06-b 10.15844/pedneurbriefs-8-1-11 Vascular Disorders Neurology Pediatrics Nervous System Diseases Child Development Brain Diseases Neurosurgery Child Infant Aspirin-Induced Neonatal Intracranial Hemorrhage http://orcid.org/0000-0002-0173-7931 Millichap J. Gordon MD 1 2 * Division of Neurology, Children's Memorial Hospital, Chicago, IL Departments of Pediatrics and Neurology, Northwestern University Feinberg School of Medicine, Chicago, IL Correspondence: Dr. J. Gordon Millichap, E-mail: jgmillichap@northwestern.edu 01 1994 01 06 2016 8 1 6 7 Copyright: © 1994 The Author(s) 1994 This work is licensed under the Creative Commons Attribution 4.0 International License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited. Severe intracranial hemorrhage in a term neonate associated with maternal acetylsalicylic acid ingestion

A term newborn infant with intracranial hemorrhage associated with maternal acetylsalicylic acid ingestion before delivery is reported from the Departments of Pediatrics and Neurology, Eastern Virginia Medical School, Norfolk, VA.

 Neonatal Intracranial Hemorrhage Hematocrit Gastric Hemorrhage

A term newborn infant with intracranial hemorrhage associated with maternal acetylsalicylic acid ingestion before delivery is reported from the Departments of Pediatrics and Neurology, Eastern Virginia Medical School, Norfolk, VA. Pregnancy was complicated by alcohol abuse. Alka-Seltzer, 6 tablets daily, had been taken for 2 weeks for relief of hangover. The infant’s serum salicylate level at 8 hours was 5.4 mg/dL. Hematocrit decreased from 29% at birth to 15% at 6 hours of age. Prothrombin time was >100 sec. Cranial ultrasound showed hemorrhage in the tentorium and hydrocephalus. CT also revealed a large cerebellar hemorrhage. Clinical findings included multiple ecchymoses, gastric hemorrhage, hematuria, a tense fontanelle, head circumference at the 95th percentile, hypotonia, and ocular bobbing and nystagmus. Transfusion, a second injection of vitamin K, and ventriculoperitoneal shunt were followed by recovery and discharge in care of grandmother on day 23. [1]

COMMENT. Maternal salicylate ingestion should be considered in the etiology of neonatal intracranial hemorrhage without birth trauma. The infant’s relatively low salicylate level is not inconsistent with chronic toxicity.

Surfactant therapy for respiratory distress syndrome in newborns of 600-750 g birth weight caused an increased risk of grades I and II intracranial hemorrhage compared to controls, in analyses of the literature by researchers at Ross Laboratories, Columbus, OH. [2]

 Karlowicz MG White LE Severe intracranial hemorrhage in a term neonate associated with maternal acetylsalicylic acid ingestion Clin Pediatr 1993 Dec 32 12 740 743 10.1177/000992289303201206 8275608 Gunkel JH Banks PLC Surfactant therapy and intracranial hemorrhage: review of the literature and results of new analyses Pediatrics 1993 Dec 92 6 775 786 8233736