Intracranial hemorrhage in infants due to vitamin K deficiency

We report five operated cases of intracranial hemorrhage complicated by vitamin K deficiency. The age of five infants were between 16 and 35 days and all of them were breast-fed. Four cases were male and one was female. As initial symptoms, two cases had convulsions, three had paralysis, and two had anisocoria. All cases showed the symptoms and signs of increased intracranial hypertension with vomiting and tense anterior fontanel. All cases showed severe anemia on admission. Prothrombin time and partial thromboplastin time were markedly prolonged. Three cases had subdural hematoma and other two cases had a combination of subarachnoid, subdaral, intracerebral and intraventricular hemorrhages. After administration of vitamin K, burr hole was performed in one case with subdural hematoma and craniotomy was performed in the other four cases. Two cases had a good result without any neurological deficit, but the other three cases had hemiparesis and mental retardation. Vitamin K deficiency usually occurs in breast-fed infants between 2 weeks and 2 months after birth, and the prognosis is poor when multiple intracerebral hemorrhages occur. Therefore we believe that the prophylactic administration of vitamin K is most important and will decrease the incidence of intracranial hemorrhage due to vitamin K deficiency.