[Neonatal subdural hematoma secondary to tentorial tearing--clinical analysis on 48 survived cases]

In order to evaluate the treatments of subdural hematoma in neonates and to observe their prognosis, we carried out clinical analyses on 48 survived cases in the past three years from Jan. 1979 to Dec. 1981. Based on CT observations, hematomas were grouped into four types according to their locations as follows: Type I, localized around the posterior interhemispheric fissure in 25 cases (52%); Type II, extending from the posterior interhemispheric fissure to the hemispheric convexity in five cases (10%); type III, extending from incisura to the posterior fossa in 15 cases (31%); and type IV, having subdural hematoma accompanied by intracerebral hemorrhage in three cases (7%). Intracranial pressure was measured via the anterior fontanelle in 13 cases. Ten patients who had extensive hemorrhage were found to exceed above 200 mmH2O in the pressure. Ages of the patients studied were 0 to 7 days old. There were 36 mature infants (75%) and 12 cases immature (25%). The maternal history of delivery was primiparous in 27 cases (56%). The fetal presentations were 38 cephalic (79%) and 10 suction deliveries (21%). The fundus oculi was examined on 32 patients. Retinal hemorrhage was noted in 12 cases. Operations were performed on 13 patients in total; one case in type I, four cases in type II, five cases in type III and three cases in type IV. Functional prognoses were found to be as follows; Type I; normal, 15 cases, abnormal, four and undetermined, six: type II; normal, four and abnormal, one: type III; normal, 13, abnormal, one, and undetermined, one: and type IV; normal, two and abnormal, one case.