Disappearing subdural hematomas in children

Area of Science:

• Pediatric Traumatology
• Neuroradiology

Background:

• Subdural hematomas (SDHs) in infants and young children are rare, often linked to nonaccidental trauma or significant impact.
• Distinguishing traumatic from non-accidental injuries is critical in pediatric cases.

Observation:

• Four pediatric cases of unilateral convexity SDHs following seemingly minor household falls or falls from a window are presented.
• Clinical symptoms in these cases were disproportionate to the reported trauma severity.
• Hematomas showed spontaneous resolution within 1-2 days post-injury.

Findings:

• These collections may represent a distinct entity, potentially located partially within the subarachnoid space.
• Radiographic and clinical features differentiate these 'disappearing subdurals' from typical SDHs.
• The mechanism involves minor trauma leading to transient, self-resolving subdural collections.

Implications:

• Accurate recognition of these benign SDHs is crucial to avoid misdiagnosis of nonaccidental trauma.
• Avoidance of unnecessary surgical intervention for these spontaneously resolving lesions.
• Understanding these entities refines diagnostic criteria for abusive head trauma.