Posttraumatic Intralaminar Hematoma Developing between Cranial Dural Layers: A Case Report.

Area of Science:

• Neuroscience
• Pediatric Traumatology
• Neurosurgery

Background:

• Head injuries in children can lead to various intracranial pathologies.
• Dural hematomas are typically epidural or subdural, but rare presentations exist.

Observation:

• A 2-year-old child sustained a head injury with altered sensorium and left-sided weakness.
• CT scan revealed a parietal fracture with a biconvex hematoma.
• Intraoperative findings showed a fibrous membrane, identified as the endosteal dura layer, separating from the meningeal layer.

Findings:

• A unique post-traumatic hematoma was identified between the two layers of the cranial dura.
• The hematoma was successfully evacuated after incising the outer endosteal dural layer.
• Post-evacuation, the distinct endosteal and meningeal dural layers were visualized.

Implications:

• This case highlights a rare dural cleavage hematoma following pediatric head trauma.
• Accurate intraoperative identification of dural layers is crucial for managing such injuries.
• Early surgical intervention resulted in a favorable outcome with no neurological sequelae.