Treatment of cerebral - meningeal hemorrhage in children

The article was professionally consulted with Specialist Doctor II Le Thanh Cam - Pediatrician - Pediatrics - Neonatology - Vinmec Danang International General Hospital.

Intracerebral - meningeal hemorrhage in children is a very dangerous disease, but it can be prevented, limited sequelae and cured if detected early. The treatment of meningitis in children is mainly symptomatic, etiological and supportive treatment.

Hemorrhagic - meningeal is a condition in which a child has bleeding in the brain or meninges. The cause of cerebral hemorrhage in children is the rupture of any blood vessel in the brain. The disease has a high mortality rate and leaves severe sequelae for patients.
Hemorrhagic - meningitis in children is a serious acute disease caused by many causes such as traumatic brain injury, hematologic pathology... However, blood clotting disorder due to vitamin K deficiency is the main cause of children with meningitis.
Vitamin K is a substance involved in the synthesis of some clotting factors in the liver. If the body lacks these clotting factors, it is easy to bleed. Most meningitis in infants is mainly due to vitamin K deficiency, usually appearing at 30-40 days of age or above. And the cause of vitamin K deficiency in young children is because:
Some young children have to take antibiotics early to treat diseases or children with digestive disorders also cause less vitamin K in the intestine to be synthesized; Vitamin K is provided from the mother to the fetus through the placenta during pregnancy, but this amount is very small and the baby will absorb vitamin K mainly through breast milk after birth. However, vitamin K in breast milk is also very little, this amount of vitamin K will vary from about 20-30 micrograms/liter; If the mother does not eat enough nutrition in the last months of pregnancy or the mother eats a diet after giving birth, the amount of vitamin K in breast milk will be less and the breastfed baby will not receive enough vitamin K need. essential for the body; In the case of young children at birth, the bacteria capable of synthesizing vitamin K in the intestines are not enough, so the child will be more susceptible to vitamin K deficiency, leading to a higher rate of brain hemorrhage in newborns compared to those who are born. older children. Pregnant women who use certain drugs such as isoniazid, barbiturates or dioxins during pregnancy are more likely to have bleeding after giving birth than children of those who do not take the drug during pregnancy.

Vitamin K deficiency is the main cause of meningitis in children. Meningeal hemorrhage in children usually occurs very quickly and the child will have the following signs:
The child's skin suddenly turns pale with signs of the baby refusing to feed, vomiting, crying a lot and whining. The child's fontanel swells and stretches; Intracerebral hemorrhage in a child will cause the child to have generalized convulsions or partial seizures in one limb, drooping eyelids, coma; In most cases, the child has irregular breathing or sometimes stops breathing, this is a warning that the child is in a very critical condition; Children with bleeding, bruising on the skin. For some babies in the first week after birth, the baby will have prolonged umbilical bleeding, bruised injection site. Therefore, when there is bleeding in the umbilicus, the injection site or the child's skin, promptly take the child to a medical facility for treatment and prevention of cerebral hemorrhage in the child, causing other dangerous complications. . Have the child do tests to show anemia, a lumbar puncture shows a blood-tinged pink discharge. In the case of children with cerebral - meningeal hemorrhage, even with intensive treatment, the mortality rate is very high, ranging from 25-40%, or leaving sequelae 40-50%. Some of the most common sequelae in children with meningitis are as follows:
Epilepsy; Children with motor paralysis; Meningeal hemorrhage in children causes mental retardation in children; The sequelae of hydrocephalus left children with lifelong disabilities.

It is a very dangerous disease, but it can be prevented, limited sequelae and cured if detected early. The treatment of meningitis in children is mainly:
Treatment of anemia: Blood transfusion 20ml/kg and Vitamin K injection 5mg x 3 days in a row Treatment of cranial hypertension syndrome, reducing cerebral edema: Using Mannitol 20% with a dose of 0.5g/kg x 2 times/day every 8 - 10 hours, need a rapid infusion rate of 40 drops/min, for 2-3 days. Then give the child another infusion of Ringer Lactate 40-50ml/kg/day. Dexamethasone 0.4mg/kg IV x 2 times/day, for 2-3 days. In case if the fontanelle is still inflated, use Lasix x 1.5-2mg/kg IV, repeat injection after 8-10 hours, control electrolytes. Closely monitor the child's consciousness, pulse, and breathing rate and give oxygen if breathing is slow. Nutrition for children with cerebral hemorrhage: Eat sonde in sufficient quantity and quality. Supportive treatment: Using neuroprotective drugs, Cerebrolysin 0.2ml/kg intravenously for 10 days and Nootropin 50mg/kg/day, orally.

To prevent cerebral - meningeal haemorrhage in children, during pregnancy, mothers need:
Mothers during pregnancy should take care of their health and nutrition necessary for their bodies; Get more vitamin K through foods. Some foods contain a lot of vitamin K such as green vegetables, milk, eggs, cereals, tofu, beef... Should be injected intramuscularly with vitamin K 5mg for pregnant mothers in the last 2 weeks before giving birth. After birth, vitamin K should be supplemented for children by one of the following two methods:
Use the injection method for all new-born babies with a dose of vitamin K1 at a dose of 1mg or an injection of vitamin K3 with a dose of 2mg. All newborns need to take vitamin K1 2mg, 3 times, once after birth, a second time at 7 days old, and a third time at 1 month old.

However, the best method is to give the baby 1 injection right after birth. All babies, including term and preterm infants, are healthy and weak. To protect children's health, parents should do well to exclusively breastfeed their babies for the first 6 months (if possible) and vaccinate on schedule. As soon as the child shows symptoms such as anorexia, fatigue, crying, it is necessary to take the child to the hospital to be consulted by a specialist for monitoring and treatment. The pediatric department at Vinmec International General Hospital is the address for receiving and examining diseases that infants and young children are susceptible to: viral fever, bacterial fever, otitis media, pneumonia in children. With a system of facilities, modern medical equipment, sterile space, minimizing the impact as well as the risk of disease spread, Vinmec will bring satisfaction to customers. and is highly appreciated by industry experts with:
Gathering a team of leading pediatricians: including leading experts with high professional qualifications (professors, associate professors, doctors, Master's degree), experienced, worked at major hospitals such as Bach Mai, 108.. The doctors are all well-trained, professional, conscientious, knowledgeable about young psychology. In addition to domestic pediatric specialists, the Department of Pediatrics also has the participation of foreign experts (Japan, Singapore, Australia, USA) who are always pioneers in applying the latest and most effective treatment regimens. . Comprehensive services: In the field of Pediatrics, Vinmec provides a series of continuous medical examination and treatment services from Newborn to Pediatric and Vaccine,... according to international standards to help parents take care of their baby's health from birth to childhood. Advanced techniques: Vinmec has successfully deployed many specialized techniques to make the treatment of difficult diseases in Pediatrics more effective: neurosurgery - skull surgery, stem cell transplantation blood in cancer treatment. Professional care: In addition to understanding children's psychology, Vinmec also pays special attention to the children's play space, helping them to play comfortably and get used to the hospital's environment, cooperate in treatment, improve the efficiency of medical treatment.