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Subdural hemorrhage and hypoxia in infants with congenital heart disease

Patrick Kelly1, Rebecca Hayman2, Lara S Shekerdemian3

  • 1Te Puaruruhau (Child Protection Team), Department of Pediatrics, Faculty of Medical and Health Sciences, University of Auckland, New Zealand; patrickk@adhb.govt.nz.

Pediatrics
|August 27, 2014
PubMed

Insights

Subdural hemorrhage (SDH) is common in infants with congenital heart disease but not linked to hypoxia. These small hemorrhages typically resolve within three months.

Area of Science:

  • Pediatric Neurology
  • Neonatal Cardiology
  • Radiology

Background:

  • Infantile subdural hemorrhage (SDH) has been hypothesized to be linked to hypoxia.
  • Congenital heart disease (CHD) in infants presents unique physiological challenges.

Purpose of the Study:

  • To determine the incidence of SDH in infants with CHD.
  • To investigate the potential relationship between hypoxia and SDH in this population.

Main Methods:

  • A prospective longitudinal cohort study involved infants undergoing cardiac surgery in Australia and New Zealand.
  • Serial brain MRI scans and oxygen saturation recordings were analyzed for 152 infants within the first three months of life.
  • Infants were categorized by degree of hypoxia to assess statistical relationships with SDH.

Main Results:

  • Subdural hemorrhage (SDH) was detected in 66 (43%) of 152 infants, with 145 loci identified.
  • New SDH occurred in 12 infants post-cardiac surgery; 63% were supratentorial.
  • No statistically significant relationship was found between hypoxia and the presence or development of SDH.

Conclusions:

  • Asymptomatic SDH is prevalent in infants with CHD, similar to infants without CHD.
  • While SDH locations can mimic abusive head trauma, they are typically small and self-resolving.
  • This study found no evidence to support an association between hypoxia and SDH in infants with congenital heart disease.
Abstract

Keywords:
abusive head traumahypoxianeonatessubdural hemorrhage

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