Idiopathic chronic subdural hematoma in the newborn: case report

Abstract

We present our case with a newborn baby with CSH without known etiology. Short literature review and possible etiological factors are observed.

Idiopathic chronic subdural hematoma, MCA infarct and cortical atrophy with status epilepticus in infants

“…Unrecognized in utero trauma and a complex interaction of intracranial and intrauterine pressures seem to be the most convincing explanation for such cases. 2,4,5,8 This is multifactorial in origin. Fragile cerebral vasculature of the infantile brain coupled with enlarged subarachnoid spaces, makes it prone to minor and unrecollected maternal abdominal trauma.…”

“…[1][2][3][4][5] The diagnosis is established only after excluding known causes of chronic subdural hematoma in infants, most common being birth trauma, hemorrhagic diathesis and metabolic disorders. 6,7 Various possible etiological factors can be hypothesized for development of such entity in infants.…”

“…Our literature search by electronic media revealed only 5 cases of chronic subdural hematoma without known etiology. [1][2][3][4][5] Unrecognized in-utero trauma and a complex interaction of intracranial and intrauterine pressures seem to be a convincing explanation for such cases. Subtle degree of birth asphyxia could also be a possible etiological factor.…”

A case for an in utero etiology of chronic SDH/effusions of infancy

“…These diagnoses have followed work-ups, prompted by alarming prenatal ultrasound abnormalities, fetal symptoms, known trauma or immediate post-partum clinical findings. [3][4][5] However, clinically silent cases of intracranial extra-axial pathology arising in utero would likely go unnoticed until emerging symptoms after birth raised concerns.…”

The Shaken Baby Syndrome: An Odyssey -II Origins and Further Hypotheses-

“…13) Subdural hematoma has also been reported anecdotally in utero. 11,12) Modern-day first world obstetrics has quite obviously reduced the incidence of severe birth trauma, but today intracranial bleeding is still recognized as a consequence of even normal uncomplicated term vaginal delivery. A comparison in fetal and maternal mortality between current first world and third world countries, and even in the U.S.A. and Japan in the first half of the 20th century, 13,24,26) would give a truer index of human birth-related injuries, and would seem to be a fruitful area for further objective research comparing human parturition with that of nonhuman primates.…”