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

Bipin Bihari Rout1, Santosh Navi1, Raju S M1

  • 1Paediatrics, All India Institute of Medical Sciences Raipur, Raipur, Chhattisgarh, India.

BMJ Case Reports
|January 6, 2026
PubMed

Insights

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)PediatricsSickle cell diseaseStroke

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