Shirai S, Owada M, Fujita Y, Akimoto M, Hayashi M
No To Shinkei. 1976 Dec;28(12):1359-64.
A one-month-old male infant with spontaneous intracerebral and subdural hematomas due to vitamin K deficiency was described. He was breastfed. Loose stools continued and began to contain blood. He had fever, vomiting and convulsion, and became drowsy. The blood studies showed anemia and hypoprothrombinemia. Left carotid angiograms revealed intracerebral and subdural hematomas. He was treated successfully by immediate operation and administration of vitamin K. 2) Vitamin K deficient hemorrhage beyond the immediate newborn period was discussed with reference in the literature. Three etiologic factors included, decreased vitamin K intake, decreased intestinal absorption of vitamin K and decreased production of vitamin K by colon bacteria. The most important factor of the three seemed to be low vitamin K intake. Intracranial hemorrhage was recognized in about one third of the cases in the literature. It was emphasized that vitamin K deficiency occurring beyond the immediate newborn period was very important as a cause of intracranial hemorrhage in infancy.
本文描述了一名1个月大的男婴,因维生素K缺乏导致自发性脑内和硬膜下血肿。该婴儿为母乳喂养。腹泻持续且开始出现便血。他有发热、呕吐和惊厥症状,并变得嗜睡。血液检查显示贫血和低凝血酶原血症。左侧颈动脉血管造影显示脑内和硬膜下血肿。通过立即手术和补充维生素K,他得到了成功治疗。2)参考文献讨论了新生儿期过后维生素K缺乏性出血的情况。三个病因包括维生素K摄入减少、肠道对维生素K的吸收减少以及结肠细菌产生维生素K减少。这三个因素中最重要的似乎是维生素K摄入不足。文献中约三分之一的病例出现了颅内出血。强调新生儿期过后发生的维生素K缺乏作为婴儿颅内出血的一个原因非常重要。