Swift Spontaneous Regression of a Pediatric Traumatic Acute Subdural Hematoma

Hille Koppen; Enrico Arkink; Anna Nordbeck; Lilian Sie; Niels van der Gaag

doi:10.1159/000504468

Swift Spontaneous Regression of a Pediatric Traumatic Acute Subdural Hematoma

Case Rep Neurol. 2019 Dec 16;11(3):351-356. doi: 10.1159/000504468. eCollection 2019 Sep-Dec.

Authors

Hille Koppen^{1

2}, Enrico Arkink³, Anna Nordbeck¹, Lilian Sie⁴, Niels van der Gaag⁵

Affiliations

¹ Hagaziekenhuis, Department of Neurology, The Hague, The Netherlands.
² Leiden University Medical Center, Department of Neurology, Leiden, The Netherlands.
³ Landspitali University Hospital, Department of Radiology, Reykjavik, Iceland.
⁴ Hagaziekenhuis, Department of Pediatric Neurology, The Hague, The Netherlands.
⁵ Hagaziekenhuis, Department of Neurosurgery, The Hague, The Netherlands.

Abstract

We report the case of a 4-year-old girl with acute subdural hematoma who presented to the emergency department after an unwitnessed fall of the balcony. The hematoma was hyperdense along the left convexity of 9 mm thickness with a consequent mass effect with obliteration of the adjacent sulci, left lateral ventricle compression and a midline shift of 7 mm. During her stay in the emergency department while waiting for transfer to the children intensive care unit elsewhere she slightly deteriorated neurologically. Repeat CT scan of the brain 4 h after initial presentation remarkably showed that the subdural hematoma had now largely disappeared, with a decrease in volume and density. Consequently, the mass effect diminished with a near normalization of the midline shift.

Keywords: Acute subdural hematoma; Children; Operation; Trauma.

Publication types

Case Reports