[Treatment for Subdural Hematoma in Infants]

This chapter will discuss the treatment for infant subdural hematoma. In adult cases, treatment focused on intracranial pressure(ICP)management alone is generally sufficient, but in infant cases, special ingenuity is required. First, there are some points to keep in mind regarding surgical procedures. It is important to perform blood transfusion from an early stage, avoid exposure of bleeding points, and reduce ICP by floating the bone flap that preserves blood flow. Next, it is necessary to understand the pathophysiology peculiar to infants. Extensive lower density changes seen on head computed tomography can have a profound effect on clinical outcome. This phenomenon should not be considered as simple cerebral ischemia, but is representative of the brain damage caused by status epilepticus and hyper perfusion injury. Therefore, not only ICP management, but also treatment for status epilepticus is extremely important for postoperative management. Further, cases where abuse is the cause of subdural hematoma often display poor outcomes due to a variety of medico social factors.