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[Subdural hematoma in infants. Indications and results of external subdural derivation]
J Maheut1, M A Barthez, C Billard
1Service de Neurochirurgie Infantile, Hôpital Gatien de Clocheville, Tours.
Insights
Simple treatments like external drainage effectively resolve chronic subdural hematoma (S.D.H.) in infants. Early intervention with these methods leads to complete S.D.H. resolution in most cases.
Area of Science:
- Pediatric Neurosurgery
- Neurology
Context:
- Chronic subdural hematoma (S.D.H.) is a significant concern in infants.
- Management strategies for S.D.H. in this age group require careful consideration.
Purpose:
- To evaluate the efficacy of simple therapeutic methods for chronic subdural hematoma in infants.
- To assess clinical and radiological outcomes following surgical intervention.
Summary:
- Twenty infants with chronic S.D.H. underwent treatment via tapping, burr-hole irrigation, or external drainage.
- External drainage was the most common method, particularly for bilateral cases.
- Clinical and CT scan analyses showed complete S.D.H. resolution in most cases, though some infants experienced neurological or psychomotor impairments.
Impact:
- Simple, early-realized therapeutic methods are generally sufficient for acute S.D.H. in infants.
- This study highlights the effectiveness of minimally invasive procedures in managing infant S.D.H.
- Findings support prompt surgical intervention for favorable radiological outcomes.
Abstract:
20 infants presenting with a chronic subdural hematoma (S.D.H.) including 15 boys and 5 girls from 1.5 to 16 months (mean age 6.3 months) were treated by tapping (1 case) or irrigation through burr-holes (2 cases) or external drainage (17 cases). The drainage was performed on both sides when the S.D.H. was bilateral (13 cases). Results were analyzed clinically and by C.T. scan. No sequela was noted in 10 cases while in 10 others persisted some neurological (5 cases) or psychomotor (4 cases) impairment or an epileptic status (1 case). In all but one case, the S.D.H. disappeared completely on C.T. scan controls. Therefore, in case of acute S.D.H., we consider that simple therapeutic methods, if early realized, are generally sufficient.