Fetal Hemoglobin in the Diagnosis of Neonatal Subarachnoid Hemorrhage
Edward R. Chaplin M.D.1,
Murren A. Schlueter B.S.1,
Roreric H. Phibbs M.D.1,
Joseph A. Kitterman M.D.1, and
William H. Tooley M.D.1
1 Cardiovascular Research Institute and the Departments of Pediatrics and Neurology, University of California San Francisco, California
Intracranial hemorrhage is a leading cause of mortality and morbidity in newborn infants, particularly those born prematurely.1-8 Major intracranial hemorrhage in the preterm infant is usually intraventricular.3-6 Although intraventricular hemorrhage is a common autopsy finding, it may be difficult to diagnose before death because its early signs are also often associated with cardiopulmonary disease.3-7 Thus, particularly in prematurely born infants with severe hyaline membrane disease, there may be no pathognomonic sign of intracranial bleeding and often only a presumptive clinical diagnosis can be made. Laboratory diagnosis based on bloody spinal fluid may also be misleading, since the blood in the spinal fluid could be the result of either a traumatic lumbar puncture or preexisting subarachnoid blood.
