[The influence and outcome of acute infantile intracranial hematoma with hypoxemia].
Unusually broad areas of cerebral infarction were demonstrated by CT scan in three head injured infants with acute intracranial hematoma. They revealed very characteristic CT findings including contralateral hemispheric ischemic zone. Case 1 is a 5-month-old boy who had hit his head 4 days before. On admission he was semicomatose and his respiration had suffered from generalized seizures with arterial PO2 value of 43 mmHg. CT scan revealed right subdural hematoma, and bihemispheric ischemic low density was also demonstrable. Hematoma clot weighing 10 grams was removed through emergency craniotomy, followed by external decompression. There was a marked atrophic change in the right cerebral hemisphere and contralateral frontal base during the following few months, but the basal ganglionic region, brainstem and cerebellum were hardly affected. The patient developed comparatively well mentally for the next one and a half years. Case 2 was a 2-year-old boy who had a previous history of moderate head trauma 8 hours before admission. After a lucid interval, sudden epileptic attacks hospitalized him in a condition of cardiopulmonary arrest. CT scan revealed severe epidural hematoma on the patient's right cerebrum. Emergency craniotomy was performed and hematoma 95 g in weight was removed followed by decompression. Postoperative CT showed broad ipsilateral ischemic edema including the contralateral cerebral hemisphere and brainstem. One and a half years later, the patient shows decorticated posture with ataxic respiration and negative light reflexes. Case 3 was an 8-month-old boy who had fallen down and hit his head on the floor. Status epilepticus had attacked him, causing him to be admitted in a dyspneic state.(ABSTRACT TRUNCATED AT 250 WORDS)
Kitami
K
K
Department of Emergency Medicine, Sapporo City General Hospital.
Tedo
I
I
Tsuchida
H
H
Sohma
T
T
Takeda
T
T
Tsujinaga
H
H
D000208:Acute Disease; D001933:Brain Stem / Q000503:physiopathology; D002543:Cerebral Hemorrhage / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D002544:Cerebral Infarction / Q000473:pathology; D002675:Child, Preschool; D006259:Craniocerebral Trauma / Q000150:complications; D005072:Evoked Potentials, Auditory; D006406:Hematoma / Q000473:pathology* / Q000503:physiopathology / Q000601:surgery; D006801:Humans; D000860:Hypoxia / Q000150:complications*; D007223:Infant; D008297:Male