Long-term Follow-Up of HIE
These children need neurodevelopmental follow-up in the Developmental or Neuro
clinics. This should occur at about 6 months of age and then subsequent evaluations
as dictated by the specialist. Many children "normalize" within the first year. Others
require early intervention.
S U B A R A C H N O I D and SUBDURAL H E M O R R H A G E
In the context of this passage this refers to primary subarachnoid hemorrhages which
are bleeds that are not extensions of parenchymal bleeds. Ultrasonography is not
helpful in diagnosis; CT/MRI must be performed.
The clinical presentation can vary widely from asymptomatic and an incidental finding to
infants presenting with seizures to, extremely rarely, an infant with a catastrophic
deterioration. Supportive and symptomatic treatment is the course. Small bleeds are
common in vaginal deliveries, but for a larger one or if symptomatic, evaluation is
indicated. Work-up of coagulopathies and confirmation of vitamin K administration
should be done in the symptomatic cases.
~90% of infants presenting with seizures will be normal in follow-up. Infants
presenting in catastrophic demise and survive tend to have neurologic sequelae in
follow-up.