Ultrasound-guided needle aspiration of epidural hematoma in a neonate after vacuum-assisted delivery.
BACKGROUND
Epidural hematoma (EDH) is a rare complication of vacuum-assisted delivery in neonates. Although the standard treatment of EDH is surgical evacuation via craniotomy, it is an invasive procedure in neonates, and less invasive methods may be favored for hematoma evacuation.


METHODS
We report a case of 5-day-old infant with a massive EDH, cephalohematoma, and a depressed fracture, which were secondary to a vacuum-assisted delivery and cured by ultrasound-guided needle aspiration and drainage. Neonatal EDH may be different from adult counterpart in that the former is more liquefied and is amenable to needle aspiration than the latter. Although needle aspiration is a blind procedure, addition of transcranial ultrasound not only ensures safety by visualizing the tip of the needle but also makes real-time evaluation of the residual hematoma volume possible.
Noguchi
Motomi
M
Department of Pediatrics, Saiseikai Utsunomiya Hospital, Utsunomiya, Japan.
Inamasu
Joji
J
Kawai
Fukiko
F
Kato
Emiko
E
Kuramae
Takumi
T
Oyanagi
Takayuki
T
Takahashi
Tsutomu
T
Ihara
Masahiro
M
D000328:Adult; D004322:Drainage / Q000379:methods*; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000209:etiology / Q000473:pathology / Q000601:surgery*; D006801:Humans; D007231:Infant, Newborn; D008279:Magnetic Resonance Imaging; D011247:Pregnancy; D014057:Tomography, X-Ray Computed; D018084:Ultrasonography, Interventional / Q000379:methods*; D014620:Vacuum Extraction, Obstetrical / Q000009:adverse effects