Pediatric Radiology

, Volume 26, Issue 11, pp 779–781

Subdural hemorrhage as an initial sign of glutaric aciduria type 1: A diagnostic pitfall


  • J. Woelfle
    • Zentrum für KinderheilkundeRhein. Friedrich-Wilhelms-Universität
  • B. Kreft
    • Abteilung für RadiologieRhein. Friedrich-Wilhelms-Universität
  • D. Emons
    • Zentrum für KinderheilkundeRhein. Friedrich-Wilhelms-Universität
  • F. Haverkamp
    • Zentrum für KinderheilkundeRhein. Friedrich-Wilhelms-Universität

DOI: 10.1007/BF01396200

Cite this article as:
Woelfle, J., Kreft, B., Emons, D. et al. Pediatr Radiol (1996) 26: 779. doi:10.1007/BF01396200


The case of a 9-month-old girl with glutaric aciduria type 1 (GA 1) is reported. On initial presentation at 6 months of age, the patient demonstrated bilateral subdural hemorrhages and widening of the basal cisterns. After neurosurgical intervention the subdural effusions regressed; their etiology remained unclear. At the age of 9 months the patient presented again because of progressive loss of psychomotor abilities and a dystonic movement disorder. Cerebral MRI revealed regressive subdural hematoma, but marked frontotemporal atrophy as well. Because of a suspected metabolic disorder, urinary analysis of organic acids was performed. This repeatedly showed marked excretion of glutaric acid, 3-hydroxyglutaric acid and glutaconic acid, indicating a diagnosis of GA 1. Considering our patient's history, we recommend the inclusion of GA 1 in the differential diagnosis of patients with unexplained subdural hematoma and neurological deficits.

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© Springer-Verlag 1996