If your child is at risk of or has been diagnosed with fetal and neonatal alloimmune thrombocytopenia (FNAIT), your doctor may have informed you of the risk of severe FNAIT, which could lead to intracranial hemorrhage (ICH), otherwise known as bleeding in the brain.
If treated early, FNAIT is not likely to result in ICH. However, if it occurs, any injury to the brain can lead to long-term neurological consequences, even if the bleed or event is short-lived.
Thrombocytopenia is a condition that predisposes patients to uncontrolled bleeding. While an infant or fetus affected by FNAIT is at risk of bleeding in any part of the body, bleeding in the brain is particularly dangerous because the skull is not flexible, and bleeding can result in extreme, even fatal, pressure in the skull.
Learn more about FNAIT signs and symptoms
What happens to the brain?
It is difficult to immediately predict what kind of effect an ICH can cause because every bleeding episode is different. Generally, the type of impairment in brain development that ICH can cause depends on several factors, including:
- When the bleeding occurs (ie, before or after birth)
- The severity of the bleeding
- The location of the bleeding in the brain
- The types and timing of interventions initiated
- How long it took doctors to identify the bleed
The immediate task for doctors should ICH be detected is to clinically stabilize the patient and ensure that the bleeding is stopped.
What happens next?
It is only after the child is stabilized and out of immediate danger that doctors think about the kinds of long-term damage to the brain. This is often not an easy task, especially in newborns, because certain cognitive and movement tests cannot be conducted at such a young age.
Medical imaging of the brain can show the extent of the bleeding and abnormal changes to the brain, but how this translates into real life is challenging to predict. However, given that ICH has occurred in the child, doctors will likely pay closer attention to their neurodevelopment as they age.
Over time, you may notice your child is showing signs that could indicate neurological abnormalities. These often include milestone delays relative to your child’s peers. Regardless of their symptoms, it’s important that your doctor closely monitors your child’s progress and, if needed, refer your child to specialists who are skilled in handling the particular symptoms they are experiencing.
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