Disappearing subdural hematomas in children.
Subdural hematomas in infants and young children are uncommon, usually occurring from nonaccidental trauma in infants or from trauma associated with motor vehicles. We report 4 children with apparent unilateral convexity subdural hematomas, 3 of which occurred from household falls and 1 occurring from a fall out of a window. These injuries were characterized by clinical symptoms consistent with the apparent forces involved, which were relatively minor in the first three instances. The clots resolved spontaneously within the first 1-2 days after injury. Such collections are likely located at least partly within the subarachnoid space, but may mimic more clinically significant subdural hematomas. Their recognition may influence decisions regarding both surgical evacuation and the likelihood of nonaccidental injury. Clinical and radiographic features distinguishing these 'disappearing subdurals' from more typical subdural hematomas are discussed.
Duhaime
A C
AC
Division of Neurosurgery, Hospital of Philadelphia, University of Pennsylvania School of Medicine, Philadelphia, USA.
Christian
C
C
Armonda
R
R
Hunter
J
J
Hertle
R
R
D000058:Accidental Falls; D001924:Brain Concussion / Q000000981:diagnostic imaging; D002649:Child Abuse / Q000175:diagnosis / Q000331:legislation & jurisprudence; D002675:Child, Preschool; D005260:Female; D005500:Follow-Up Studies; D016489:Head Injuries, Closed / Q000000981:diagnostic imaging*; D006408:Hematoma, Subdural / Q000000981:diagnostic imaging*; D006801:Humans; D007223:Infant; D008297:Male; D009460:Neurologic Examination; D011859:Radiography; D012075:Remission, Spontaneous; D012887:Skull Fractures / Q000000981:diagnostic imaging; D013701:Temporal Bone / Q000000981:diagnostic imaging / Q000293:injuries