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Chronic expanding epidural haematoma. Case report
T Watanabe1, K Nakahara, Y Miki
1Department of Neurosurgery, National Cancer Center Hospital, Tokyo, Japan.
Acta Neurochirurgica
|January 1, 1995
Summary
A rare case of epidural hematoma in a child expanded slowly over months due to rebleeding from its membrane. This highlights the potential for chronic expansion in epidural hematomas, mimicking subdural hematomas.
Area of Science:
- Neurosurgery
- Pediatric Neurology
- Traumatic Brain Injury
Background:
- Epidural hematomas (EDHs) are typically associated with acute symptoms following head trauma.
- Chronic expansion of EDHs is uncommon, often presenting with delayed neurological deficits.
Observation:
- A 9-year-old boy presented with symptoms 5 months after a minor head injury.
- Imaging revealed an encapsulated fluid epidural hematoma.
- The hematoma was successfully evacuated via a burr hole procedure.
Findings:
- Clinicopathological analysis suggested repeated microhemorrhages from the hematoma membrane caused chronic expansion.
- This process led to a significant delay in clinical manifestation.
Implications:
- This case suggests that chronic expanding epidural hematomas can occur, particularly in pediatric patients.
- The hematoma membrane plays a crucial role in the chronic expansion of EDHs.
- Clinicians should consider chronic expanding EDH in the differential diagnosis of delayed post-traumatic neurological symptoms.