Traumatic brain injury unmasking Vitamin B12 deficiency in an infant with long-term follow-up

Abstract

Falls are very common in infancy and toddler age group. We are presenting a case of insignificant fall from the cot causing severe neurological problems in an infant due to previous underlying relatively asymptomatic vitamin B12 deficiency. A six-month-old female infant presented with a fall from a cot followed by altered sensorium, vomiting, right focal seizures, and right sided weakness. On examination, a low Glasgow coma scale (8/15), right sided weakness (MRC power of 3/5 in the right upper and lower limbs), with anaemia were noted. Investigations revealed left frontal contusion with haemorrhage, megaloblastic anaemia, and thrombocytopenia with low vitamin B12 level. The child improved with symptomatic management of raised intracranial pressure and injectable vitamin B12 supplements. Prompt intervention and appropriate treatment led to favourable outcomes in the infant, highlighting the importance of recognizing and addressing concomitant deficiencies in infants with TBI.