title: Massive subdural haematoma: an unusual complication of septicaemia in preterm very low birthweight infants.
abstract: Non-traumatic massive subdural haematoma is a rare condition in newborn infants and is usually associated with hereditary coagulation disorders or congenital vascular malformation. Its occurrence in preterm very low birthweight infants secondary to systemic bacterial infection has not been reported. We describe two extremely preterm neonates who developed massive subdural haematoma as a result of gram-negative septicaemia and disseminated intravascular coagulation. Both infants suffered severe parenchymal cerebral injury and hydrocephalus. Clinicians should be aware of this unusual and catastrophic complication if a very low birthweight infant with severe sepsis and disseminated intravascular coagulation suddenly deteriorates despite successful treatment with antibiotics. Radiological imaging by cranial ultrasound or computed tomography scanning should be routinely considered in all such infants for the detection of intracranial bleeding.
authors.affiliation: Department of Paediatrics, Prince of Wales Hospital, The Chinese University of Hong Kong, Shatin, New Territories.
authors.forename: P C
authors.initials: PC
authors.lastname: Ng
authors.forename: T F
authors.initials: TF
authors.lastname: Fok
authors.forename: C H
authors.initials: CH
authors.lastname: Lee
authors.forename: W
authors.initials: W
authors.lastname: Wong
authors.forename: K L
authors.initials: KL
authors.lastname: Cheung
mesh_terms: D016470:Bacteremia / Q000000981:diagnostic imaging*; D004292:Dominance, Cerebral / Q000502:physiology; D004927:Escherichia coli Infections / Q000000981:diagnostic imaging; D005066:Euthanasia, Passive; D005260:Female; D005317:Fetal Growth Retardation / Q000000981:diagnostic imaging*; D006408:Hematoma, Subdural / Q000000981:diagnostic imaging*; D006801:Humans; D006849:Hydrocephalus / Q000000981:diagnostic imaging; D007231:Infant, Newborn; D007235:Infant, Premature, Diseases / Q000000981:diagnostic imaging*; D019102:Infant, Very Low Birth Weight; D007710:Klebsiella Infections / Q000000981:diagnostic imaging; D007711:Klebsiella pneumoniae; D018447:Medical Futility; D014057:Tomography, X-Ray Computed