Can Vitamin K Prevent Hemorrhagic Strokes?

Hemorrhagic disease is a life-threatening condition that can affect newborns shortly after birth. Vitamin K, crucial for normal clotting, might not be present at adequate levels in newborns, resulting in the potential for an intracerebral hemorrhage. An intramuscular injection of vitamin K right after birth can prevent this hemorrhagic disease. The use of vitamin K in adults to prevent hemorrhagic stroke is limited to excess anti-coagulation therapy and to treat intracerebral hemorrhage in certain cases.

Vitamin K

Vitamin K is absent or at low levels in the newborn and requires replacement immediately after birth to prevent potential bleeding and hemorrhagic stroke. Infants who are not treated risk serious neurological damage if bleeding occurs. Vitamin K is effective when used in adults to treat coagulation disorders and hemorrhagic strokes but is not routinely given to prevent hemorrhagic stroke or blood disorders.

Types

Three areas of bleeding occur in newborns with vitamin K deficiency: early, classic and late. Early bleeding occurs within the first 24 hours after birth. Bleeding is unavoidable if the mother is taking medications that interrupt vitamin K clotting action, such as anti-convulsants or warfarin. Daily vitamin K, taken during the third trimester, can avoid this problem. Classic bleeding occurs within five days after birth and is related to low vitamin K in breast milk and an absence of normal flora in the intestine of the newborn. Late bleeding occurs two to 12 weeks after birth, usually presents as an intracranial hemorrhage and results from not receiving vitamin K or other complications, such as malabsorption and cystic fibrosis.

Risk Factors

Vitamin K, a fat-soluble vitamin, can only pass the placental barrier from mother to fetus in small amounts, leaving the fetus with low vitamin K levels at birth. Infants at risk to bleed include those who are not treated right after birth with intramuscular vitamin K. Additionally, infants born at home who are not treated and those completely dependent on breast milk are also susceptible. Mothers requiring medications for seizure disorders increase the infant's vulnerability to bleeding.

Symptoms

Symptoms that raise suspicion of a deficiency of vitamin K include bleeding from the umbilical cord site, bloody bowel movements or urine, and unexplained bleeding from mucous membranes such as the nasal lining and mouth. A bulging fontanelle, or soft spot, at the top of the infant's head can indicate intracranial hemorrhaging. Prognosis for late bleeding is worse than for early or classic, with the tendency for bleeding inside the skull much higher, and its consequences of brain damage or death more severe.

Adult Hemorrhagic Stroke

Excess anti-coagulants, such as warfarin, increase the risk of bleeding in the brain. Vitamin K is useful if the risk of bleeding is extremely high. Otherwise, treatment consists of monitoring and withdrawal of the anti-coagulant. An intracerebral hemorrhage, or bleeding within the brain, results from chronic high blood pressure that weakens the lining of arteries in the brain. An acute headache is the primary symptom, treatable with supportive care, including pain medication, vitamin K, transfusions and possibly surgery.