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BABY AND CHILDHOOD NERVOUS SYSTEM AND MUSCLE DISORDERS: HAEMORRHAGES IN THE BRAIN
Sometimes the brain suffers from a sudden haemorrhage. This may result from a blow or from the spontaneous rupture of a weakened vessel.
Subarachnoid haemorrhage
Subarachnoid haemorrhage may take place 24-48 hours after an accident to the head. Headaches, nausea and vomiting may occur, and this develops into lethargy and finally unconsciousness. There may be a fever and neck stiffness.
Small haemorrhages may not cause too much damage and the patient may gradually improve and get better. With massive bleedings, large amounts of the brain may be destroyed and the outlook is grave. Convulsions and cerebral palsy may result.
Subdural haematoma
Subdural haematoma means a haemorrhage on the outer side of the brain has occurred. It may follow a difficult birth, or in older children may be the first indication of a battered child who has receive maltreatment purposely.
It is often difficult to establish the diagnosis, for symptoms may be variable and difficult to elicit. The infant may be irritable, fail to thrive, vomit, have a low-grade fever, and not take his feeds normally. The head may be enlarged. In older children there may be headaches, vomiting, convulsions and, later, loss of consciousness.
Children with these symptoms will usually wind up at a large hospital for full investigation. The treatment is for the accumulating mass of blood to be removed by so-called 'sub-dural taps'. Fluid is removed each day from the intra-cranial region. Provided the brain has not been damaged too greatly, the results are often dramatically good.
Extradural haematoma
This means a vessel in the brain has ruptured and it usually follows a head injury. This is most likely over the temples. The child may be momentarily stunned. After seeming to be normal for an hour or more, he may lapse into sleepiness and then unconsciousness. He may even slip into a coma or have convulsions.
Often these wind up as surgical emergencies, and surgical treatment is often excellent.
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General Health
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