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Hemophilia and child abuse as possible causes of epidural hematoma: case report

Fernando Campos Gomes Pinto1, Fabrizio Frutos Porro, Liliana Suganuma

  • 1Neurosurgery Division, Neurology and Neurosurgery Department, University of São Paulo Medical School, São Paulo, SP, Brazil.

Arquivos De Neuro-Psiquiatria
|February 6, 2004
PubMed

Insights

Child abuse can cause head trauma, but epidural hematoma in a child with hemophilia A highlights the importance of considering non-abuse etiologies even with severe injuries.

Area of Science:

  • Pediatric Traumatology
  • Hematology
  • Child Abuse Forensics

Background:

  • Head trauma is a significant indicator of child abuse, often leading to intracranial hemorrhages through mechanisms like whiplash shaken-baby syndrome.
  • Epidural hematomas are less commonly associated with child abuse compared to other intracranial injuries.

Observation:

  • A case report details an infant who sustained an epidural hematoma after minor head trauma.
  • Initial suspicions of child abuse were raised due to the injury's severity relative to the reported trauma mechanism.

Findings:

  • Further investigation revealed the child had undiagnosed hemophilia A, a bleeding disorder.
  • This diagnosis provided an alternative explanation for the epidural hematoma, independent of abuse.

Implications:

  • The case underscores the necessity of a comprehensive differential diagnosis in suspected child abuse cases involving head trauma.
  • It emphasizes considering underlying medical conditions, such as bleeding disorders, especially when trauma mechanisms appear disproportionate to injury severity.
Abstract

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