Infantile acute subdural hematoma
Etiology
Diagnosis
Diagnosis can be made by computed tomography or magnetic resonance imaging 1).
Large subdural hematoma of the right convexity up to 3 cm thick, which causes severe cerebral compression, with cingulate herniation and transtentorial herniation.
The hematoma shows liquid-liquid levels, with a higher density lower in relation to sedimented hematoma.
Signs of diffuse brain edema.
Treatment
The ideal treatment for subdural hematomas (SDHs) in infants remains debated.
Outcome
Early recognition and suitable treatment may improve the outcome of this injury. If treatment is delayed or the condition is undiagnosed, acute subdural hematoma may cause severe morbidity or even fatality 2).
Infantile acute subdural hematoma case series
Case reports
Q5434
A 1 year old , according to anamnesis provided by the parents, they consulted in the last month for cough clinic with low expectoration, nasal congestion, Tº up to 38ºC of 24 hrs evolution. According to an emergency report: the previous week the patient presents right facial edema, of 2 days duration.
Scratch injuries in legs.
In the next days vomiting with progressive decay.
In the following hours after admission coma, respiratory arrest with bradycardia
Large subdural hematoma of the right convexity up to 3 cm thick, which causes severe cerebral compression, with cingulate herniation and transtentorial herniation.
The hematoma shows liquid-liquid levels, with a higher density lower in relation to sedimented hematoma.
Signs of diffuse brain edema.
In the surgical intervention xanthochromia appears at the beginning, later dark red liquid without clots. Later a subdural membrane is seen on the arachnoid surface, very characteristic of chronic subdural hematoma.