Alexander had his MRI today and it revealed that he had a small bleed in the right frontal lobe of his brain approximately two or three days ago (based on the observation that the blood that was found was old blood which indicates that whatever vessel popped, it’s already been repaired which was a good sign. The age of the blood indicates that it happened either right before delivery or during the delivery. The good news (if you can imagine it) is that it was definitely a small bleed and not a stroke…if you have something like this going on, you definitely want the former.
They’re not really sure what caused this…theories include abnormal vessels in the brain that popped due to the pressure of pregancy as the most likely. But they are saying that if you’re going to have a complication such as this, his age and the location of the bleed combine to make it so that a child up to three years old has a much better chance of recovering from an injury such as this than an adult would.
Unfortunately, the brain doesn’t take kindly to blood just sitting on it, blood is irritating to the brain and thus you tend to see seizure activity.
But now that we know what caused his seizures and that it’s pretty much repaired itself, the question is now what can we expect and the answer is a pretty big we don’t know as of yet. If there is going to be any long-term problems from the bleed in that particular area, it’s expected to manifest itself as difficulties with attention, focus, and and behavior. There aren’t any expectations that actual cognition / intelligence will be affected. Another MRI will be taken probably in about two or three months once the swelling has gone down in his brain and that’ll shed a lot more light on what we can expect going forward. And there is a fair chance that Alexander might not suffer any ill effects at all. But he will be watched very closely to see if there are any additional seizures (which is complicated by the fact that the manifestation may well change over time from what he was doing as new pathways are formed). He’ll probably be on the phenobarb for four to six months and then be allowed to outgrow it or if there are additional difficulties, he will be switched to some other medication if necessary (as it was explained to us, phenobarb is wonderful for little ones up to six months…after that, it tends to mess with cognition).
To sum up: for a sucky situation, this was the best possible news we could hope for!
He’s getting excellent care from some of the best pediatric neurologists in the business and now that we know what to watch for, whatever follow-on effects come of this are treatable with available therapies so there is no reason Alexander can’t have a happy and healthy life. We’ll just be better prepared to watch for and correct any problems that we see with his development and that’s not necessarily a bad thing.
Unfortunately, this means that like his older brother, we won’t be bringing him home when Mommy comes home. But it’s better to make sure that we’ve really passed the acute phase so that he doesn’t have to make a U-turn right back into NICU even though emotionally, we’d rather have him come home straightaway.
Thanks for the continued good wishes for his well-being…they were very much appreciated, particularly for the last 48 hours! 🙂
