Non‐traumatic subarachnoid Hemorrhages in Children beyond the Neo‐Natal Age.

Abstract

Summary. The author points out that subarachnoid hemorrhages are considerably rarer in children than in adults. He has collected 58 cases from the literature, and adds to these a case observed by himself. Besides, there are in the literature reported a little over 30 cases of subarachnoid hemorrhage due to rupture of an intracranial aneurysm. The disease is seen in children of all ages, oftenest towards the age of puberty, though in about one‐third of cases in children under 4 years old. He describes the symptoms and emphasises that in the case of children who suddenly become unconscious examination of the spinal fluid should always be done. The prognosis cannot be given until the disease has lasted some days. About 60 per cent recover. Not a few of these (in his material 8 of 29) get recurrences; follow‐up examinations in adult cases but not made among children seem to show that also the possibility of more or less lasting after‐effects must be counted with in some cases. The cause of the hemorrhage can be demonstrated with more or less certainty in about 50 per cent of the cases. The author calls particular attention to the fact that K‐avitaminosis was the indubitable cause in 2 cases of infants, 3…4 months old. In the remaining 50 per cent, the cause was probably rupture of an aneurysm; whereas diapedesic hemorrhage on angioneurotic basis can hardly, … except perhaps in a couple of cases, … be thought in children to be as important an etiologic factor as several authors believe it to be in adults. The treatment consists in regulation of the pressure in the subarachnoid space by means of repeated evacuations of spinal fluid. In special cases blood transfusion, vitamin‐K, antiluetic treatment and chemotherapeutic remedies will be the causal treatment. So far as possible, the etiologic diagnosis should therefore always be established.