a. Intracranial hemorrhage is caused by trauma or anorexia in utero or at the time of birth.

It most frequently occurs in preterm neonates but may also be found in full-term babies. Difficult and very rapid deliveries are often associated with intracranial hemorrhage.

b. Symptoms depend on the areas of hemorrhage and the amount and extent of the hemorrhage. It may be subtle or pronounced, occur at birth, or within several days following birth.

(1) Low APGAR scores.

(2) Irregular respirations.

(3) Cold, pale, and clammy skin.

(4) Bulging or tense fontanels.

(5) Unequal pupils.

(6) Diminishing moro reflex.

(7) Opisthotonos.

(8) Seizures.

c. Medical and nursing interventions.

(1) Keep the infant in a quiet environment.

(2) Avoid stressful or stimulating procedures.

(3) Monitor respiratory functions and temperature instability.

(4) Feed as tolerated.

(5) Administer sedatives and/or vitamin K as ordered.

d. Prognosis depends on the severity of the hemorrhage and the precipitating factors.

Some neonates demonstrate mild symptoms with few effects while others may progress to seizuring and death. Survival after a severe case increases the risk of permanent cerebral damage, hydrocephalus, mental and neurologic impairment, and cerebral palsy. And in addition, hydrocephalus may be present. This is excessive accumulation of cerebrospinal fluid (CSF) within the ventricular spaces of the brain-causing enlargement of the head.