Evaluation of prevention effectiveness of intracranial hemorrhage with vitamin K injection for newborns

Background: Intracranial hemorrhage (lCH) is a common disease with high rate of mortality and neurological sequel. Objectives:to estimate preventive effectiveness of intracranial hemorrhage by vitamin K1 and K3 for newborns just after birth". Subjects and methods: An epidemiological, randomized control study with intervention was conducted. The study included all children under 3 months with and without ICH during period 1/1/2000 -30/6/2004 living in Hatay province. Among them all the newborns during period 1/6/2002 - 30/6/2004 were injected either 1 mg vitamin K1 or K3. Results: Children injected with vitamin K in the intervention period were followed up in three months and evaluated by a united process. Effects of intervention were calculated by preventive value. 62.057/82069 newborns were injected vitamin K1 or Vitamin K3 (25.725 newborns were injected Vitamin K1; 36.332 newborns were injected vitamin K3). Single dose 1M reduced the rate of ICH in infants: The morbidity changed from 3.3\ufffd?to 0.82\ufffd? the prevention value was 96%. There were no complications and side effects of vitamin K injections reported. Conclusions: Injection of vitamin K1 and K3 have similar preventive effectiveness. Vitamin K injection 1M with recommended dose was safe for newborns.\r\n', u' \r\n', u'\r\n', u'

Clinical Study on intracranial Arteriovenous Malformations: Clinical Analysis of 187 Cases

In an effort to understand the clinical symptomatology of intracranial arteriovenous malformations(AVMs), to determine their best management policy, and to accumulate our clinical data, a retrospective clinical analysis of 187 patients with intracranial AVMs which were diagnosed by neuroradiological studies or histopathologically was performed during the period from January 1983 to May 1994. Among the 187 patients of whom for patients with dural type AVM and eight referral patients were excluded, 120 patients were treated surgically and the other 55 patients, managed conservatively. The outcome of all patients were analysed and their post-ictal status was followed for an average of 31.7 months. The results were as follows. 1) The peak incidence of intracranial AVMs was in the third decade(mean age 28.9 years) followed by the second decade and the fourth decade. The male to female ration was 1.9:1. 2) The presenting symptoms were mainly intracranial hemorrhage(50.3%), seizure(33.2%) and headache(9.6%). Among the types of intracranial hemorrhage, intracerebral hematoma was the most frequent, and of the seizure type, generalized seizure was seen most frequently. 3) The locations of intracranial AVMs were hemispheric(78%), deep seated(14%), posterior fossa(6%), and dural(2%). 4) The presenting symptoms of intracraial hemorrhage and seizure depended significantly on the size of the AVM;71% of small AVMs(6cm) presented with seizure. 5) The rate of rebleeding was 21%(20 of 94) and the associated mortality rate was 5%( of 20). 6) Concomitant aneurysms were found in 14 cases(7.5%). 7) In surgically treated cases, the mortality rate was 2.5% and its morbidity rate, 26.7%. In conservatively treated cases, the mortality rate was 3.6% and its morbidity rate, 27.3%. 8) The clinical outcome of children was similar to that of adults. 9) Patients with seizures showed a better outcome than those with hemorrhages and the clinical outcome did not depend on the methods of treatments in either patients with hemorrhages or those with seizures. 10) With respect to the Spetzler-Martin grade, the surgical outcome improved ssignificantly as the grade became lower. 11) There was a marked tendency for postoperative neurological deficits to improve with time during the mean follow-up period(31.7 months). As such, early morbidity rate was 50% and late morbidity rate decreased to 26.7%. 12) Preoperative embolization was effective for a safe surgical removal of the AVMs with a poor grade. 13) Of the patients who did not have seizure before surgery, 7.9%(6/76) had late seizures in whom all were not well controlled with medication. Of the patients who had seizures before surgery, 82.9%(29/35) were either cured or controlled with medication.