Abstract
Introduction
Neonatal traumatic head injuries (NTHI) can be life-threatening and require aggressive treatment. The indications, techniques, and results of brain decompression are not well defined in the literature.
Methods
We studied prospectively cases of NTHI with intracranial traumatic lesions; skull fractures without underlying lesions were not included. We treated 17 cases of NTHI: 7 patients had a subdural hematoma, 3 had an extradural hematoma, and the others had subarachnoid hemorrhage. Surgical evacuation of intracranial clots was performed in 7 cases, by needle aspiration in 5 and by craniotomy in 2 patients with extradural hematomas.
Results
The outcome was favorable in all but one patient, who had hemophilia A, and died of rebleeding at the age of 2 months.
Conclusion
Surgical decompression of intracranial hematomas due to NTHI is often unnecessary; however, it may be required in emergency because of poor clinical tolerance. Whenever possible, percutaneous needle aspiration is the treatment of choice.
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References
Aoki N (1990) Epidural haematoma in the newborn infant: therapeutic consequences from the correlation between haematoma content and computed tomography features. Acta Neurochir 106:65–67
Avrahami E, Frishman E, Minz M (1993) CT demonstration of intracranial hemorrhage in term newborn following vacuum extractor delivery. Neuroradiology 35:107–108
Castillo M, Fordham LA (1995) MR of neurologically symptomatic newborns after vacuum extraction delivery. Am J Neuroradiol 16:816–818
Chamnanvanakij S, Rollins N, Perlman JM (2002) Subdural hematoma in term infants. Pediatr Neurol 26:301–304
Govaert P (1993) Cranial haemorrhage in the term newborn infant. Clinics in developmental medicine, vol 129. MacKeith, London
Govaert P, Calliauw L, Vanhaesebrouck P, Martens F, Barrilari A (1990) On the management of neonatal tentorial damage. Eight case reports and a review of the literature. Acta Neurochir 106:52–64
Harpold TL, McComb JG, Levy ML (1998) Neonatal neurosurgical trauma. Neurosurg Clin N Am 9:141–154
Hayashi T, Hashimoto T, Fukuda S, Ohshima Y, Moritaka K (1987) Neonatal subdural hematoma secondary to birth injury: clinical analysis of 48 survivors. Childs Nerv Syst 3:23–29
Holland E (1922) Cranial stress in the foetus during labour and on the effect of excessive strength on the cranial contents. J Obstet Gynaecol Br Emp 29:549–571
Hoskote A, Richards P, Anslow P, McShane T (2002) Subdural haematoma and non-accidental head injury in children. Childs Nerv Syst 18:311–317
Hovind KH (1986) Traumatic birth injuries. In: Raimondi AJ, Choux M, Di Rocco C (eds) Head injuries in the newborn and infant. Springer, Berlin Heidelberg New York, pp 87–109
Leestma JE (1995) Forensic neuropathology. In: Duckett S (ed) Pediatric neuropathology. Williams and Wilkins, Baltimore, pp 243–283
Levene MI, deVries LS (1995) Neonatal intracranial hemorrhage. In: Levene MI, Lilford RJ, Bennett MJ, Punt J (eds) Fetal and neonatal neurology and neurosurgery, 2nd edn. Churchill Livingstone, Edinburgh, pp 335–366
Myles LM, Massicote P, Drake J (2001) Intracranial hemorrhage in neonates with unrecognized hemophilia A: a persisting problem. Pediatr Neurosurg 34:94–97
Perrin RG, Rutka JT, Drake JM, Meltzer H, Hellman J, Jay V, Hoffman HJ, Humphreys RP (1997) Management and outcomes of posterior fossa subdural hematomas in neonates. Neurosurgery 40:1190–1200
Pierre-Kahn A, Renier D, Sainte-Rose C, Flandin C, Hirsch JF (1970) Acute intracranial hematoma in neonates at term. A propos of 17 cases. Ann Pediatr 32:419–425
Sörensen N (1986) Effects on head form of intrauterine compression and passage through the birth canal. In: Raimondi AJ, Choux M, Di Rocco C (eds) Head injuries in the newborn and infant. Springer, Berlin Heidelberg New York, pp 83–85
Whitby EH, Griffiths PD, Rutter S, Smith MF, Sprigg A, Ohadike P, Davies NP, Rigby AS, Paley MN (2004) Frequency and natural history of subdural haemorrhages in babies and relation to obstetric factors. Lancet 363:846–851
Williams B (1977) Difficult labour as a cause of communicating syringomyelia. Lancet 2:51–53
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Vinchon, M., Pierrat, V., Tchofo, P.J. et al. Traumatic intracranial hemorrhage in newborns. Childs Nerv Syst 21, 1042–1048 (2005). https://doi.org/10.1007/s00381-004-1131-z
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DOI: https://doi.org/10.1007/s00381-004-1131-z