PubMed · 11043373
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S Shimada. 2000. [Subdural hematoma].. https://pubmed.ncbi.nlm.nih.gov/11043373/
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Subdural hematomas are uncommon in term infants. The study objectives were to evaluate risk factors for and clinical significance of small subdural hematomas observed on computerized tomography. During a 3-year period, 26 near-term and term nonasphyxiated infants were found to have a subdural hematoma on computed tomography. Clinical indications for computed tomography were respiratory symptoms in 15 infants and neurologic symptoms in 10 infants; one infant had a skull fracture. Subdural hematomas were less than 3-mm maximum transverse dimensions in all infants: location was infratentorial (n = 7), supratentorial (n = 7), and in both sites (n = 12). Four infants also had evidence of edema and hemorrhage within the anterior temporal lobe. Delivery was vaginal in 25 of 26 infants, and forceps were used in 13 (50%) infants. Twenty-five infants were managed expectantly; one infant underwent surgical elevation of a depressed skull fracture. No infant required surgical evacuation of the subdural hematoma. At discharge, nine infants with subdural hematoma exhibited an abnormal examination, i.e., mild hypotonia (n = 7) and Erb's palsy (n = 2). The clinical syndrome attributed to subdural hematoma was most often a subtle clinical problem. The presence of subdural hematoma documented by computed tomography is not necessarily always indicative of birth trauma and may occur as sequelae of an otherwise uncomplicated delivery.
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We report an unusual case of spontaneous acute spinal subdural hematoma. To date, only a few cases of magnetic resonance imaging (MRI) demonstration of such a pathology have been reported in the medical literature. We analyse the pathogenesis, clinical presentation, magnetic resonance imaging results, intraoperative findings and prognosis of this rare condition. We would like to stress that prompt and non-invasive diagnosis by MRI sagittal sections leads to efficient surgical treatment.