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[Three infants with epidural hematoma]
S J Schade1, S T Lie, J M Draaisma
1Afd. Kindergeneeskunde, Sint Elisabeth Ziekenhuis, Hilvarenbeekseweg 60, 5022 GC Tilburg.
Insights
Infants experiencing head trauma can develop epidural hematomas with minimal symptoms. Prompt surgical decompression is crucial for recovery in these pediatric cases.
Area of Science:
- Pediatric Neurosurgery
- Trauma Care
- Neonatal Medicine
Background:
- Epidural hematomas are a significant cause of morbidity and mortality, particularly in children.
- Infantile epidural hematomas present unique challenges due to anatomical differences, such as open fontanelles.
Observation:
- Three infants (two males, one female, aged 5-10 months) presented with drowsiness and emesis post-fall without loss of consciousness.
- Radiological imaging confirmed epidural hematomas in all three infants.
Findings:
- Emergency surgical decompression was performed, leading to a good recovery for all infants.
- Infantile epidural hematomas can manifest with subtle symptoms, differing from older children and adults.
- The open fontanelle in infants allows for slower compression but can result in greater blood loss, potentially causing anemia and hypovolemic shock.
Implications:
- Highlights the importance of considering epidural hematomas in infants with minimal head injury symptoms.
- Emphasizes the need for prompt diagnosis and surgical intervention in pediatric epidural hematomas.
- Underscores the potential for severe complications like anemia and shock due to delayed recognition in infants.
Abstract:
Three infants, two boys aged 10 months and one girl aged 5 months, developed drowsiness and emesis within a few hours of a fall (after which they had not lost consciousness). Radiological examination revealed an epidural haematoma which was treated with emergency decompression. The children subsequently made a good recovery. An epidural haematoma is a potentially life-threatening event. More than 20% of all cases of epidural haematoma occur in childhood. In contrast with distinct symptoms in most adults and older children, an epidural haematoma in infancy can have a minimum of symptoms. The open fontanelle means compression occurs less rapidly, but consequently blood loss can be greater, leading to acute anaemia, hypovolaemic shock and consumptive coagulopathy.