Case 92 – update part A

Thanks for your help so far

An 8 week old baby boy born at 40+2 by Normal vaginal delivery has a CT that confirms a subdural haemorrhage.

Results: (With age adjusted reference ranges)

  • FBC – Hb 120 (Low) MCV 120 (upper normal) plt 200 (Normal) Wcc 15 (Normal) Retics 220 (upper normal range)
  • Coag – PT 74 secs (High) APTT 55 sec (upper normal) Fib 2 (Normal). PT corrects on mixing.
  • Film– unremarkable with normal platelet morphology.

The team give Vitamin K 1mg IV as severe bleeding.

The mother is well apart from epilepsy. She has no previous pregnancies. She is not in consanguineous relationship. She reports the boy was well no bleeding of umbilical stump or mucocutaneous bleeding noted. He was on 50th centile for weight. He is exclusively breastfed.

What is the most likely cause of this presentation?

How should this be managed?

What is the relevance of maternal epilepsy in this case?

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