First case report of spontaneous posterior fossa subdural hemorrhage – A rare cause of neonatal encephalopathy

Sreedhara, M S; Ninan, Binu; Prakash, Ayyadurai; Visvanathan, Kala; Shekhar, Ravi; Devi, Usha

doi:10.1016/j.jocn.2019.05.047

Cited by 1 publication

(7 citation statements)

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“…Acute presentation from brainstem dysfunction or delayed presentation with signs and symptoms of hydrocephalus are the major clinical findings. 1 , 4 , 11 Clinical findings of PFSDHs can be nonspecific mimicking or coexisting with neonatal hypoxic-ischemic encephalopathy. In these patients, early screening trans-fontanelle ultrasound is required.…”

Section: Discussionmentioning

confidence: 99%

“…However, neonates with hematoma thickness >15mm; signs of progressive brainstem compression such as apnea, bradycardia, and hypotension; and acute obstructive hydrocephalus should promptly get an operative intervention. 1 , 4 , 5 , 13 …”

Section: Discussionmentioning

confidence: 99%

“… 1 , 4 , 5 According to Perrin et al case series, severely affected neonates had supratentorial parenchymal injuries in addition to their PFSDHs, indicating a more severe degree of brain damage. 1 …”

Section: Discussionmentioning

confidence: 99%

“…Neonates can present either with an acute presentation in the first few hours of life with brain stem dysfunction from compression or delayed presentation with signs of hydrocephalus. 1 , 4 , 5 Breech presentation, prolonged delivery, instrumentation with forceps or vacuum, primiparity, and extreme multiparity are the most frequent factors associated. 6 , 7 The option of management can be conservative, burrhole craniostomy, or suboccipital craniectomy based on the clinical presentation.…”

Section: Introductionmentioning

confidence: 99%

“…There are less than 100 cases described in the literature. 1 Chronic PFSDH at this age is an even rarer disease entity, reported in only two cases 2,3 (Table 1). Neonates can present either with an acute presentation in the first few hours of life with brain stem dysfunction from compression or delayed presentation with signs of hydrocephalus.…”

Section: Introductionmentioning

confidence: 99%

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Neonatal Spontaneous Bilateral Posterior Fossa Chronic Subdural Hematoma and Obstructive Hydrocephalus with a Successful Outcome: A Case Report

Bergene,

Tira,

Hussen

et al. 2023

IMCRJ

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Background Chronic supratentorial subdural hematoma is uncommon in neonates but accounts for most neurosurgical procedures in neonatal age. However, its occurrence in the posterior fossa is extremely rare. It can be caused by instrumental delivery, coagulation abnormality, hypoxic insult, and various structural abnormalities. Furthermore, spontaneous onset has been reported only in a few case reports. Case Presentation A twenty-nine-day-old male neonate presented with failure to suck for three days duration associated with vomiting. Imaging showed bilateral posterior fossa chronic subdural hematoma and obstructive hydrocephalus. Bilateral burrhole craniostomy and hematoma evacuation was done which resulted in an excellent outcome. Conclusion Posterior fossa chronic subdural hematoma is extremely rare in the neonatal period. It can be caused by various possible etiologic agents; however, rarely it can occur spontaneously. Management with suboccipital burrhole craniostomy and hematoma evacuation can result in a good outcome. Intraoperative monitoring and management with an experienced anesthesiology team are indispensable for a good outcome. Study Setting Pediatrics neurosurgery ward, St Peter’s Comprehensive Specialized Hospital, Addis Ababa, Ethiopia.

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Section: Discussionmentioning

confidence: 99%