Intracranial Hemorrhage (Patient Information)

An intracranial hemorrhage (ICH) is bleeding in an infant's head. This bleeding can occur in the area around the ventricles (the place where spinal fluid is made) or inside the ventricles, and/or in the brain tissue itself.
What causes an ICH?
Premature babies are prone to ICH because their brain development is immature and fragile. Many times it is difficult to determine an exact cause of an ICH.
What are the symptoms?
Some infants do not show any symptoms. Other infants may have any of the following:
  • lack of breathing (apnea)
  • decreased heart rate (bradycardia)
  • seizures
  • decreased activity
  • temperature instability
  • blood pressure fluctuations
  • blood sugar changes
  • anemia
  • or bulging fontanel (soft spot)
How is it diagnosed?
An ultrasound may be performed to check for areas of bleeding. Ultrasounds pass waves over the infant's soft spot to create a picture on a screen of the infant's brain. This test can be performed at the infant's bedside and no sedation is needed; it does not cause the infant any pain. Occasionally, a test called a CT scan may be done to diagnose bleeding in the head. This test uses a computerized x-ray machine to take cross-section pictures.
What is the treatment?
The treatment for an ICH depends on the severity of the bleeding. Minor bleeds may not require any treatment and the blood may be re-absorbed by the body. The infant may need to have excess fluid removed by spinal taps. If the tissues that re-absorb spinal fluid become irritated or scarred, spinal fluid might accumulate and cause a condition know as hydrocephalus. Your baby's doctor will discuss this with you if it occurs.
Future Expectations:
It is often difficult to tell if an infant will have long-term problems as the result of an ICH or what those problems may be. Therefore, a infant with an ICH will need ongoing evaluations by the doctors to determine his/her outcome and follow-up appointments will be necessary.