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Extradural haematoma in infants.

J R Leggate1, N Lopez-Ramos, L Genitori

  • 1Department of Paediatric Neurosurgery, Hôpital des Enfants, La Timone, Marseille, France.

British Journal of Neurosurgery
|January 1, 1989
PubMed
Summary

This study analyzed 40 infants with extradural hematomas (EDH), finding falls were the most common cause. Most EDH were parietal or temporal, with middle meningeal artery bleeding being frequent.

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Area of Science:

  • Pediatric Neurosurgery
  • Trauma Surgery
  • Pediatric Neurology

Background:

  • Extradural hematomas (EDH) are a significant cause of pediatric head injury.
  • Understanding the clinical and operative characteristics of EDH in infants is crucial for effective management.
  • This study reviews a historical cohort of infants treated for EDH.

Purpose of the Study:

  • To present the clinical and operative findings of 40 infants treated for EDH.
  • To analyze the causes, symptoms, locations, and outcomes of EDH in this pediatric population.
  • To compare findings across different age groups within infancy.

Main Methods:

  • Retrospective review of 40 infants treated for EDH between 1960 and 1988.
  • Categorization of infants into three age groups: <6 months, 7-12 months, and 13-24 months.
  • Analysis of etiological factors, clinical presentation, radiological findings, surgical sources of bleeding, and patient outcomes.

Main Results:

  • Falls (less than 1m or greater than 1m) were the most common cause (70%).
  • Drowsiness (60%) and delayed vomiting (45%) were key symptoms; 47.5% presented with anemia.
  • Parietal, temporal, or temporo-parietal locations predominated (75%); middle meningeal artery was the most frequent bleeding source (42.5%).
  • Mortality was 12.5% and morbidity was 15%, including motor deficits and epilepsy.

Conclusions:

  • Infantile EDH, often caused by falls, presents with specific clinical and radiological features.
  • Prompt diagnosis and surgical intervention are vital for improving outcomes in pediatric EDH.
  • The findings highlight the importance of considering EDH in infants with head trauma, even with seemingly minor mechanisms of injury.

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