[Posterior fossa subdural hematoma in neonates: report of two cases and review of the literature].
Posterior fossa subdural hematoma in neonates caused by birth trauma is rare; only 30 clinical cases can be found in the literature so far. Here we experience two similar cases and review that literature. Case #1 is that of a full-term female born in the pelvic position. At 21 hours after birth she developed convulsions and a CT scan revealed a high-density area, mainly in the right posterior fossa. On the fourth day, a right suboccipital craniectomy was performed and about 15 ml of hematoma was removed. At present her mental and somatic development is appropriate for her age (5 months), despite the fact that moderate brain atrophy was seen in the CT scan taken at 4 months. Case #2 is that of a full-term female also born in the pelvic position. At 38 hours she became convulsive and opisthotonic; a CT scan revealed a high-density area in the posterior fossa. No neurological abnormality was seen thereafter, however, and she was treated conservatively. On the 18th day, the high-density area in the CT scan had almost disappeared. In the CT scan taken at 6 months moderate brain atrophy was seen, but at the present age of two she evidences quite normal development both mentally and somatically. These cases lead us to emphasize the importance of prompt diagnosis followed by removal of hematoma, and the usefulness of CT scan as a diagnostic method in clinical manifestations of this sort.
D001720:Birth Injuries / Q000150:complications* / Q000175:diagnosis; D001930:Brain Injuries / Q000150:complications* / Q000175:diagnosis; D003388:Cranial Fossa, Posterior; D005260:Female; D006408:Hematoma, Subdural / Q000175:diagnosis / Q000209:etiology* / Q000628:therapy; D006801:Humans; D007231:Infant, Newborn; D014057:Tomography, X-Ray Computed