Breaking age barriers: spontaneous epidural haematoma in a child with sickle cell disease

Bipin Bihari Rout ¹, Santosh Navi ¹, Raju S M ¹

⁰Paediatrics, All India Institute of Medical Sciences Raipur, Raipur, Chhattisgarh, India.

Bmj Case Reports +

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January 6, 2026

View abstract on PubMed

Summary

A young boy with sickle cell disease (SCD) survived a spontaneous, non-traumatic epidural hematoma (EDH), highlighting the need for vigilance in pediatric SCD patients. This case represents the youngest documented survivor of such a critical event.

Area Of Science

Pediatric Neurology
Hematology
Neurosurgery

Background

Sickle cell disease (SCD) is a genetic blood disorder associated with various complications.
Intracranial bleeding is a known but rare complication of SCD, particularly in younger patients.
Spontaneous epidural hematomas (EDH) are uncommon in children, especially those with SCD.

Purpose Of The Study

To report the case of the youngest documented survivor of spontaneous EDH in a child with SCD.
To emphasize the possibility of non-traumatic intracranial bleeding in pediatric SCD patients.
To raise awareness among emergency physicians regarding this rare but critical condition.

Main Methods

Case report of a middle childhood boy with homozygous SCD.
Clinical presentation including limb pain, altered sensorium, and signs of increased intracranial pressure.
Diagnostic imaging (Cranial CT) revealing bilateral EDH with midline shift.
Emergency surgical intervention (craniotomy) and medical management (mechanical ventilation, blood transfusion, phenobarbitone coma).

Main Results

The patient survived a large left fronto-parietal EDH with midline shift.
Successful surgical evacuation of the hematoma and intensive medical management.
Initial recovery with right hemiparesis, which significantly improved to independent ambulation.
No recurrence of EDH on follow-up.

Conclusions

This case represents the youngest documented survivor of spontaneous EDH in SCD.
Non-traumatic intracranial bleeding, including EDH, can occur in young SCD patients.
Emergency physicians must consider EDH in the differential diagnosis of pediatric SCD patients presenting with neurological deterioration.

Keywords:

Haematology (incl blood transfusion) Pediatrics Sickle cell disease Stroke