Abstract
Intracranial hemorrhage is a frequent finding at autopsy in very immature infants. Because of the possibility of therapy in whom DIC seems to be present, it was thought important to be able to time the intracranial bleed to see if it had already occurred before therapy could have been initiated. Infants at high risk for intracranial bleeding have been transfused as early in the course of their illness as possible with red cells tagged with 50chromium. 50Cr is a stable tracer which can be activated in vitro to 51Cr and counted. If the infant died and had an intraventricular clot in which >70% of the red cells were tagged, it was assumed that bleeding occurred after tagging. If the clot contained <30% tagged cells as compared to the sample of blood taken at tagging or just prior to death, it was assumed that bleeding had occurred prior to tagging. 28 such tagged infants have died and had intracranial clots analyzed for 50Cr. 16 infants had HMD, 7 extreme immaturity, the remainder died of other disorders. 18 were <1250 g. B.Wt., 23 were <32 wks. gestation. Median age of tagging was 6.3 hrs. while median age at death was 33.2 hrs. 50Cr concentrations in clot samples indicated that 25 infants had clearly bled after tagging and only 2 had already had their major bleed before tagging. 4 infants presumably had some bleeding before tagging, but continued to bleed afterwards. Investigations of the possible exchange of 50Cr tag after clot formation did not indicate significant exchange between tagged circulating red cells and those in the clot. 12 infants had clear-cut DIC, 11 possible, and 5 had no evidence of DIC. All but 1 without DIC had grossly abnormal second stage clotting values. It is concluded that most of these infants' intracranial hemorrhages occurred after birth and after their disease process was clearly established.
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Dyer, N., Gutberlet, R., Raye, J. et al. Timing of intracranial bleeding in newborn infants. Pediatr Res 5, 373 (1971). https://doi.org/10.1203/00006450-197108000-00011
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DOI: https://doi.org/10.1203/00006450-197108000-00011