Abstract
Subdural hematomas with mass effect and midline shift are typically offered urgent surgical evacuation. The authors report a 6-month-old baby who was referred for macrocephaly and found to have a large subdural hematoma with midline shift. Given her lack of symptoms and normal neurological examination, the patient was observed without neurosurgical intervention. She remained asymptomatic, and serial brain imaging showed progressive decrease of the subdural hemorrhage and complete resolution of midline shift. This case is presented to alert neurosurgeons that observation of a large subdural hematoma may rarely be appropriate in babies with open fontanelles.
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References
Bullock MR, Chestnut R, Ghajar J, Gordon D, Hartl R, Newell DW et al (2006) Surgical Management of Acute Subdural Hematomas. Neurosurg 58:S16–S24
Coşar M, Eser O, Aslan A, Ela Y (2007) Rapid resolution of acute subdural hematoma and effects on the size of existent subdural hygroma: a case report. Turk Neurosurg 17:224–227
Erol FS, Kaplan M, Topsakal C, Ozveren MF, Tiftikci MT (2004) Coexistence of rapidly resolving acute subdural hematoma and delayed traumatic intracerebral hemorrhage. Pediatr Neurosurg 40:238–240
Huang SH, Lee HM, Lin CK, Kwan AL, Howng SL, Loh JK et al (2005) Rapid resolution of infantile acute subdural hematoma: a case report. Kaohsiung J Med Sci 21:291–294
Jayawant S, Rawlinson A, Gibbon F, Price J, Schulte J, Sharples P (1998) Subdural hemorrhages in infants: population based study. BMJ 317(7172):1558–1561
Looney CB, Smith JK, Merck LH, Wolfe HM, Chescheir NC, Hamer RM (2007) Intracranial hemorrhage in asymptomatic neonates: prevalence on MR images and relationship to obstetric and neonatal risk factors. Radiology 242(2):535–541
Nagao T, Aoki N, Mizutani H, Kitamura K (1985) Acute subdural hematoma with rapid resolution in infancy: case report. Neurosurg 19:465–467
Öğrenci A, Ekşi MŞ, Koban O (2015) Spontaneous rapid resolution of acute subdural hematoma in children. Childs Nerv Syst 31(12):2239–2243
Tucker J, Choudhary AK, Piatt J (2016) Macrocephaly in infancy: benign enlargement of the subarachnoid spaces and subdural collections. J Neurosurg Pediatr 18:16–20
Whitby EH, Griffiths PD, Rutter S, Smith MF, Sprigg A, Ohadike P (2004) Frequency and natural history of subdural hemorrhages in babies and relation to obstetric factors. Lancet 363:846–851
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Fotso, C., Sandberg, D.I. Spontaneous resolution of large subdural hematoma with midline shift: a case report. Childs Nerv Syst 37, 703–705 (2021). https://doi.org/10.1007/s00381-020-04733-0
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DOI: https://doi.org/10.1007/s00381-020-04733-0