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[Traumatic extradural hematoma in childhood and normal early computed tomography: report of 2 cases]
O Ciquini Júnior1, A L Dos Santos, L A Manreza
1Departamento de Neurologia, Faculdade de Medicína da Universidade de São Paulo (FMUSP), Brasil.
Insights
Traumatic extradural hematoma can develop late in children, even after a normal initial CT scan. Close neurological monitoring is crucial for pediatric head injuries, especially with large hematomas or skull fractures.
Area of Science:
- Pediatric Neurosurgery
- Neuroradiology
- Trauma Care
Background:
- Traumatic brain injuries in children require careful management.
- Extradural hematomas are a significant concern following head trauma.
- Computed Tomography (CT) is a primary diagnostic tool.
Observation:
- Two pediatric cases presented with delayed onset of extradural hematoma.
- Initial CT scans were normal, but symptoms emerged hours later.
- Consciousness impairment was a key indicator of developing hematoma.
Findings:
- Late-developing extradural hematoma is a potential complication in pediatric head trauma.
- Serial neurological examinations are vital for early detection.
- Risk factors include large traumatic cephalohematoma and skull fractures.
Implications:
- Emphasizes the need for vigilant post-trauma observation in pediatric patients.
- Highlights limitations of early normal CT scans in ruling out delayed complications.
- Recommends extended monitoring protocols for at-risk pediatric head injury cases.
Abstract:
The cases of two children with traumatic extradural hematoma with an early normal CT scan are reported. Consciousness impairment occurred in them respectively 20 and 60 hours after admission, and CT at this occasion evidenced extradural hematoma. Serial neurological examinations are recommended for children with large traumatic cephalohematoma associated or not to skull fracture and in whom an initial early CT was normal, since they can lately develop extradural hematoma.