Intracranial Hemorrhage - Recovery

It’s not often known how long recovery will take. Continuous monitoring is necessary to assess the progression of any bleeding and whether any complications occur. Proper medical care is essential, but the actual treatments depend on the baby’s condition and symptoms. Brain hypothermia is now an accepted treatment protocol that lasts for three days. During this time, the baby and its brain are cooled to reduce the amount of damage from a lack of blood and/or oxygen.

The treatment doesn’t guarantee there won’t be long-lasting effects. Oxygen-starved brain cells are damaged quickly, and a hemorrhage can lead to permanent impairment and conditions such as cerebral palsy that may require life-long recovery and therapeutic measures. A child’s recovery following an infant brain injury or intracranial hemorrhage may involve the following complications:

• Weakness on one side: Permanent weakness is not uncommon in these situations, and often affects the arms and hands. The legs may be affected as well. Pediatric physical and occupational therapy is a way of life, and ongoing assessments and interventions can help manage complications and offer some degree of rehabilitation.
• Speech and language problems: Although not apparent right away, communication problems will start to show once a child is expected to hit milestones such as repeating sounds and identifying words. Therapy can help with the production or understanding of language or with helping a child speak more clearly. The effects of an intracranial hemorrhage may last a lifetime, but speech-language pathologists can provide the right course of treatment to maximize the child’s chances of success.
• Epilepsy: Seizures are also not uncommon following a hemorrhage. They may start right away, or it can be years before the signs of epilepsy manifest. Anticonvulsant medications can be administered from infancy, but regular monitoring is needed to manage treatment and dosages as the individual develops and grows.
• Cognitive and behavioral factors: Later effects on higher-order brain functions may not be obvious for years. Even if a baby seems to have recovered, learning problems can appear later on. These include attention deficit hyperactivity disorder, for which there are medications that can offer potential treatments. Behavioral interventions may work as well. The recovery process is therefore ongoing and can include examinations by pediatric neuropsychologists and other medical professionals. Parents, teachers, and other childhood education experts encompass a series of integrated professionals who can work towards a more positive outcome and quality of life.

Intraventricular Hemorrhage (IVH) and Recovery

An IVH involving the germinal matrix, an important part of a newborn baby’s brain where cells form, can have lasting consequences. It can impair the growth of gray matter and the cerebellar hemisphere. Interference with precursor cells (particularly neurons and astrocytes), may prevent these from migrating to where they belong. A subdural hemorrhage, which often doesn’t have symptoms in a term newborn, may be due to the rupture of an important vein. If large enough, it can affect the flow of cerebrospinal fluid, and leave behind problems that can lead to further bleeding in the future.

If other hemorrhages are present, a parenchymal hemorrhagic lesion is possible. Many infants recover, but many others require shunts, lumbar punctures, and other invasive treatments. However, it is the severity of such instances that can make a recovery unpredictable. Neurosurgery may have uncertain outcomes as well but can be lifesaving and avert further injury.

A traumatic delivery can have a variety of consequences that may be immediately seen or not show up for weeks, months, or years. Quickly finding the site of any bleeding and the underlying cause, in addition to prompt medical treatment, can improve a child’s chances of recovery. For an infant, the challenges lie in predicting the effects of any potential damage to an immature brain, and in determining the potential for deficits in functions that won’t develop or be harnessed for some time.