Asymptomatic Chronic Epidural Hematoma in a Child As a Result of Extracranial Decompression.
BACKGROUND
Epidural hematoma (EDH) in children is a diagnostic challenge due to its nonspecific clinical presentation. Asymptomatic chronic epidural hematoma is a very rare entity. Reports of spontaneous decompression into the subgaleal spaces are limited with acute epidural hematomas in the literature.


OBJECTIVE
We report a child presenting with chronic epidural hematoma at 15 days after a head trauma. She remained asymptomatic, owing to spontaneous decompression via a skull fracture. We intend to remind emergency physicians to be alert about epidural hematomas in asymptomatic children in the presence of a history of, even minor and distant, trauma.


METHODS
An 8-year-old girl presented to the Emergency Department with a swelling in the right parietal region. She had fallen at the playground and struck her head on the ground 15 days prior. Computed tomography showed a mixed-density subacute-chronic parietal epidural hematoma with a linear fracture overlying it. There was no evidence of midline shift or ipsilateral ventricular compression.


CONCLUSIONS
An initially minimal but expanding EDH in a child can remain asymptomatic even in the later phases, owing to the spontaneous decompression through a skull fracture.
Department of Emergency Medicine, Faculty of Medicine, Kocaeli University, Umuttepe, Kocaeli, Turkey.
Elif
E
Yaka
Department of Emergency Medicine, Faculty of Medicine, Kocaeli University, Umuttepe, Kocaeli, Turkey.
Murat
M
Pekdemir
Department of Emergency Medicine, Faculty of Medicine, Kocaeli University, Umuttepe, Kocaeli, Turkey.
Ahmet
A
Kama
Department of Radiology, Faculty of Medicine, Kocaeli University, Umuttepe, Kocaeli, Turkey.
Hasan Tahsin
HT
Sarısoy
Department of Emergency Medicine, Faculty of Medicine, Kocaeli University, Umuttepe, Kocaeli, Turkey.
Serkan
S
Yılmaz
D058070:Asymptomatic Diseases; D002648:Child; D002908:Chronic Disease; D003664:Decompression; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000175:diagnosis* / Q000209:etiology / Q000601:surgery; D006801:Humans; D011859:Radiography; D012887:Skull Fractures / Q000150:complications* / Q000000981:diagnostic imaging
asymptomatic; child; chronic; decompression; epidural hematoma