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Did Your Newborn Suffer Cerebral
Palsy or Another Brain Injury Before
or During Labor and Delivery?

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Our Birth Brain Injury Resource Guide

the guide

Get a FREE guide of resources available throughout Ohio to children and families of children who were born with brain injuries.

Our guide can help you build a foundation of knowledge and tools that will help you help your child
now and in the future.

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Intracranial Hemorrhage Symptoms

An intracranial hemorrhage in an infant can be identified through medical imaging. As with any brain injury, however, a rapid diagnosis is critical. A person may have trouble speaking or feel dizzy if they have a bleed, but a newborn baby can’t communicate such signs. The risk of life-long disabilities and even death is high; a Neuroradiology study followed 53 full-term infants, 13 of which didn’t survive, indicating a 24.5 percent mortality rate in this research. Three of the infants developed cerebral palsy, and a few didn’t have any clinical signs of a hemorrhage but had been admitted for perinatal asphyxia or respiratory distress.

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The scope of a brain bleed can be examined through imaging and an electroencephalogram. A combination of tests can determine how to proceed with a course of treatment. Initially, one must determine the cause of symptoms that are identified via the infant’s condition and through medical examination. Although the signs aren’t always obvious, one could suspect a possible bleed after a prolonged delivery, breech delivery, or when forceps or other instruments are used to deliver the baby.

Key Signs of Intracranial Hemorrhage

Elk & Elk

There are a few symptoms, including a bulge in the soft spot on the newborn’s head, or fontanelle. The circumference of the baby’s head may increase as well. Hemorrhages can form within the brain or in a subdural region.

When symptoms do present, they often include seizures or convulsions. An infant who has suffered a stroke will often present with seizures, but repetitive chewing, sucking, or eye movements can be symptomatic as well. Jerking movements of arm, leg, or face muscles are potential signs of a problem, or various muscle groups may be excessively stiff and tight.

The baby might also stare in an unusual manner. Apnea may be present, which is a pause in breathing accompanied by a slowing of the heart. More general signs of trouble include vomiting, lethargy, fever, and a loss of consciousness, which can be associated with many other medical problems, so diagnosing an intracranial hemorrhage can be a challenge. Plus, the symptoms may vary depending on where the bleed is, which can also determine what the long-term impacts might be as the child develops.


Surgery is a possibility, especially if there is an excess amount of blood and fluid pooled up. There are various medications to manage blood pressure and seizures, but observation is often the most important part. A small amount of intracranial bleeding often resolves on its own. The medical team will continue to watch for additional symptoms while the infant is in the hospital.

Another course of treatment if the blood supply is disrupted (and therefore oxygen) is to induce brain hypothermia. If a newborn has suffered asphyxia or a generalized neurological condition known as hypoxic ischemic encephalopathy, cooling the baby can reduce the amount of brain damage. The core body temperature is reduced to between 91 and 92 degrees Fahrenheit.

During the period in which the baby is cooled, the treatment helps to preserve brain cells before they die off. Cooling therapy can also reduce hemorrhaging and other pathologies as well, such as:

  • Vasogenic cerebral oedema, a disruption of the blood-brain barrier that causes fluid leaks inside the brain.
  • A reduction of neurotransmitter activity to prevent calcium from building up in the neurons.
  • Protection of cells and cellular organelles against oxidative damage when blood flow is restored.
  • A reduction of coagulation and prevention of platelet activating factor from being released.
  • A lower number of cells that show signs of apoptosis, a biological mechanism of cell death.

For centuries, physicians have used similar techniques to resuscitate babies. The connection between hypoxia at birth and later problems wasn’t made until 1861, but neonatal therapeutic hypothermia was studied in the 1950s. The long-term outcome became more of a concern in the 1960s, but brain protection via cooling became a topic of interest within the Soviet Union. The idea became more widespread by the late 1980s as cooling therapy was successful during heart surgery, so it also became a subject of research in neurology.

Cooling is just one way to treat a baby with intracranial bleeding. The first step is to identify the symptoms, for the condition to be assessed and a prompt treatment plan to be implemented.