Related Experiment Videos
[Clinical and electroencephalographic findings in subdural effusions (report of 17 cases)]
Insights
Subdural effusions in infants, often linked to toxicoses, may be more common than previously thought. Electroencephalography (EEG) can aid diagnosis, but fontanel puncture remains crucial when results are unclear.
Area of Science:
- Pediatrics
- Neurology
- Clinical Medicine
Context:
- Subdural effusions are a significant concern in pediatric neurology.
- Etiologies include infantile enteritis, meningitis, and encephalitis.
- Traditional clinical signs are often absent in affected children.
Purpose:
- To investigate the occurrence and diagnosis of subdural effusions in infants.
- To evaluate the utility of electroencephalography (EEG) in identifying subdural fluid collections.
- To emphasize the importance of fontanel puncture when EEG findings are inconclusive.
Summary:
- This study reports on 17 infants with subdural effusions, exploring potential etiological factors.
- Toxicoses from infantile enteritis were implicated in 5 cases; meningitis and encephalitis in others.
- Electroencephalography revealed reduced potentials in most cases, but its diagnostic limitations necessitate fontanel puncture in ambiguous situations.
Impact:
- Highlights subdural effusions secondary to toxicoses as potentially underdiagnosed.
- Underscores the diagnostic value of EEG in pediatric neurological assessments.
- Recommends fontanel puncture as a definitive diagnostic tool for subdural fluid accumulation, even with non-specific EEG variations.
Abstract:
The author gives an account of 17 children aged 1 month to 1;1 years, in whom uni- or bilateral subdural effusions had occurred. Etiologically, toxicoses due to infantile enteritides were made responsible in 5 cases, pneumococcic meningitides in 3 cases, and encephalitides in 3 cases. For 6 children it was not possible to obtain clear etiological results. It is emphasized that subdural effusions subsequent to toxicoses are perhaps a more frequent occurrence than has been believed heretofore. The clinical symptomatology of subdural fluid accumulations, which is described in the literature, failed to be observed in nearly all cases. E. E. G. derivations were particularly indicated under such diagnoses as propulsive petit mal and grand mal epilepsies. Electroencephalographically, the leading characteristic symptom in 13 cases was a uni- or bilateral reduction of potentials. The derivation thus provided for an almost pathognomonic interpretation. However, by reference to the electroencephalograms of 4 other children it is possible to demonstrate that, in agreement with the information and data given in the literature, it is not possible to obtain any reliable indications of subdural accumulations of fluid. Therefore, in case of doubt one should not dispense with a test puncture of the fontanel even in case of nonspecific E. E. G. variations.