Subdural hematoma as clinical presentation of osteogenesis imperfecta

Osteogenesis imperfecta is an inherited collagenous disease. The mildest form may present with less severe findings, for example blue sclera, but can also lead to significant handicap such as deafness or multiple bone fractures. We describe an 11-month-old female in whom bilateral chronic subdural hematoma was the leading clinical presentation of osteogenesis imperfecta type I. She was hospitalized due to epileptic seizures caused by these bilateral subdural hematomas without preceding trauma. Osteogenesis imperfecta type I was diagnosed on the basis of clinical and radiologic findings. This case demonstrates that nontraumatic chronic subdural hematoma in patients with osteogenesis imperfecta type I may be caused by impaired bone calcification, vascular fragility, and permanent friction between multiple bone fragments of the skull. Osteogenesis imperfecta type I should be considered as an underlying disease in cases of nontraumatic subdural hematoma. A thorough clinical examination is recommended to exclude subtle characteristics of the disease.