| Summary: | Objective To explore clinical features of the etiology, imaging characteristics, complications and prognosis of spontaneous intracranial hemorrhage in infants. Methods Clinical data of 131 cases of spontaneous intracranial hemorrhage in infants (≤3 years old) admitted to our department from January 2011 to December 2018 were collected and retrospectively analyzed, including their clinical etiology, imaging examination results, complications, treatment methods and prognoses. Results The causes of intracranial hemorrhage in this cohort included delayed vitamin K deficiency(72 cases, 54.9%), arteriovenous malformations (16 cases, 12.2%), hemophilia (15 cases, 11.4%), other unexplained coagulation dysfunction (9 cases, 6.9%), cavernous hemangioma (5 cases, 3.8%), hypoxic ischemic encephalopathy (4 cases, 3.1%), brain tumor stroke (3 cases, 2.3%), cerebral paragonimiasis and aneurysm (both 2 cases, 1.5%), and acute leukemia, hemophilic syndrome and Sturge-Weber syndrome (all 1 case, 0.8%). All cases were diagnosed with intracranial hemorrhage by CT scanning or MRI, and for the 34 cases with suspected cerebrovascular disease, the detection rate of CTA was 100%. The complications included convulsion or seizure (86 cases, 65.6%), anemia (77 cases, 58.8%), secondary infections (46 cases, 35.1%), cerebral hernia (32 cases, 24.4%), cerebral edema (28 cases, 21.4%), cerebral infarction (27 cases, 20.6%), hydrocephalus (26 cases, 19.8%), respiratory failure (14 cases, 10.6%) and status convulsion (9 cases, 6.9%). There were 43 cases undergone surgical treatment, and 88 cases received non-surgical treatment. Glasgow outcome score (GOS) scale indicated that 100 patients (76.3%) achieved a good prognosis. The results of binary logistic regression analysis showed that cerebral edema (OR=5.794), cerebral hernia (OR=11.326) and respiratory failure (OR=8.028) were risk factors for poor prognosis in the infants with spontaneous intracranial hemorrhage (P < 0.05). Conclusion The most common cause of spontaneous intracranial hemorrhage in infants is delayed vitamin K deficiency. If the cause of hemorrhage is suspected to be cerebrovascular disease, CTA examination should be conducted as early as possible. The most common complications is convulsion or seizure. Cerebral edema, cerebral hernia and respiratory failure often indicate poor prognosis. The disease can obtain a good prognosis after active treatment.
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