Intracranial hemorrhages in infants: approaches to intensive care and correction of cerebral vasospasm. A retrospective observational study

Introduction. Vitamin K-deficient coagulopathy (VKDC) is the most common etiological cause of hemorrhagic stroke in young children. In recent years, there has been a decrease in the incidence of this pathology. However, the problem of the development of cerebral vasospasm in intracranial hemorrhages in young patients of various etiologies remains and does not lose relevance. The purpose of this work is to study the issues of intensive care, in particular, the treatment of cerebral angiospasm in children with intracranial hemorrhages (ICH). Materials and methods. A retrospective study of the medical records of 35 patients with ICH of various etiologies aged from 21 days to 4 months of life for the period from 2017 to 2021 was conducted. Patients were divided into 2 groups who received (n = 12) and did not receive the intravenous form of nimodipine (n = 8). Results. VKDC accounted for 82.8 % of all ICH cases, cerebral angiospasm developed in 57.1 %, which had a statistically significant effect (p< 0,05) on the need to continue treatment in the intensive care unit, as well as the duration of artificial ventilation. The administration of nimodipine did not increase the need for vasopressors, however, there was no statistically significant difference in the decrease in resistance indices along the middle cerebral artery, according to transcranial Dopplerography (p > 0.05). Conclusion. The problem of improving approaches to intensive care remains urgent in order to further reduce infant mortality and profound disability. Special attention is paid to the problems of cerebral vasospasm, which affects the degree of neurological deficit. However, reliable data on the effectiveness of intravenous nimodipine therapy has not been received to date due to a small group of observations, this issue requires the organization of multicenter studies.