[Special features of epidural hematoma in neonates and infants (author's transl)]

Epidural hematomas in infancy, meaning up until the closing of the cranial sutures, have special clinical manifestations and courses; four cases will be demonstrated here. Following an often mild cranio-cerebral trauma a characteristical subperiosteal hematoma lacking primary consciousness disturbance and free interval can develop. The considerable loss of blood coming from the epidural hemorrhage, of mainly venous origin, leads to an often extreme anemia and shock syndrome. Due to the combination of shock and increasing brain compression a fulminant course with sudden coma, respiratory failure and irreversible circulatory collapse can terminally occur. Thus one should always think of an epidural hematoma in cases of increasing anemia, shock syndrome and an extending cranial hematoma following a brain trauma in infancy. Rapid trepanation with shock therapy and accompaning blood transfusion allows the prognosis of the epidural hemorrhage in infancy to be essentially better than in adulthood.