Paediatric chronic subdural haematoma: what are the predisposing factors and outcomes in management of these cases?

Deora, Harsh; Mishra, Arima; Gupta, Rahul; Konar, Subhas; Vazhayil, Vikas; Shashidhar, Abhinith; Srinivas, Dwarakanath

doi:10.1007/s00381-021-05341-2

Cited by 11 publications

(9 citation statements)

References 32 publications

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“…Many studies by DEORA H et al show that any patient with or without a history of head trauma should be suspicious of whether he has chronic subdural hematoma. These patients manifest (1) Changes in mental state or deterioration of pre-existing neurological or psychological diseases, (2) Focal neurological dysfunction, (3) Progressive severe headache 4 . Headache is common in young patients, not in the elderly, which is partly due to the small intracranial space for hematoma expansion before hematoma exerts pressure on adjacent brain tissue 2 .…”

Section: Discussionmentioning

confidence: 99%

Misdiagnosis of Chronic Subdural Hematoma in Children

Peng,

Xue,

Wang

2023

Journal of Craniofacial Surgery

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Chronic subdural hematoma is a common intracranial disease in elderly individuals, but in very rare cases, it can also develop in children. Some subdural hematomas are prone to misdiagnosis as epidural hematomas, which can affect the surgical approach and patient prognosis. We report a case of a 12-year-old male child with a misdiagnosed subdural hematoma as an epidural hematoma. We reviewed the data of this misdiagnosed patient with chronic subdural hematoma, analyzed relevant imaging information, identified the reasons for misdiagnosis, and summarized our experience to enhance our understanding of this condition.

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Section: Discussionmentioning

confidence: 99%

Misdiagnosis of Chronic Subdural Hematoma in Children

Peng,

Xue,

Wang

2023

Journal of Craniofacial Surgery

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“…Although cSDH occurs more commonly in adults, it is also a cause of neurological morbidity among pediatric patients, with similar recurrence rates as adults. 21,22 Safe, effective treatment is necessary to prevent long-term neurological sequelae. Given its efficacy in the adult population, MMA embolization may also represent an effective, less invasive treatment option for pediatric patients.…”

Section: Pediatric Mma Embolizationmentioning

confidence: 99%

“…The most common cause of a cSDH in an infant is abusive head trauma; other risk factors and etiologies include cerebrospinal fluid overdrainage in a shunted patient, anticoagulation (eg, in the setting of cardiac disease), and rarely the presence of an arachnoid cyst. [22][23][24][25][26][27] In our review of the literature, the latter etiologies represented 80% of the reported cases of pediatric MMA embolization, and MMA embolization was selected rather than standard surgical treatments because of the patients' significant comorbidities, a recurrence of the SDH after primary treatment, or both. Conversely, MMA embolization seems to be less applicable to infants who are victims of abusive head trauma because of the challenges of achieving vascular access in this young age group.…”

Section: Pediatric Mma Embolizationmentioning

confidence: 99%

Middle Meningeal Artery Embolization for Primary Treatment of a Chronic Subdural Hematoma in a Pediatric Patient: A Systematic Review of the Literature and Case Report

Paro

Ollenschleger

Fayad

et al. 2022

Operative Neurosurgery

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BACKGROUND: Middle meningeal artery (MMA) embolization is becoming increasingly studied as a safe, effective treatment for chronic subdural hematoma (cSDH) in adults. Among pediatric patients, however, MMA embolization for cSDH has been rarely described, and the potential benefit of this approach for pediatric patients remains unknown. OBJECTIVE: To systematically review the literature and identify cases of pediatric MMA embolization for cSDH. We also report our experience with pediatric MMA embolization. METHODS: A systematic review of the literature was performed to identify cases of pediatric MMA embolization for cSDH. Inclusion criteria included English language availability and pediatric age defined as less than 18 years. A pediatric patient treated with MMA embolization was also identified at our institution. RESULTS: Five cases of pediatric MMA embolization for cSDH were identified in the literature. Two were associated with arachnoid cysts, 2 with antiplatelet/anticoagulation therapy, and 1 with abusive head trauma. There were no adverse events, and all patients demonstrated clinical and radiological improvement on follow-up. At our institution, a previously healthy 8-year-old male was found to have a right-sided acute-on-chronic SDH during a headache evaluation. A diagnostic angiogram was performed to rule out a dural arteriovenous fistula, and right-sided MMA embolization was performed concurrently. Rapid clinical and radiological improvement was observed, with complete resolution by 6 months. CONCLUSION: MMA embolization may represent a treatment option for pediatric patients with cSDH.

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“…Among pediatric patients, chronic subdural hematomas are most commonly associated with abusive head trauma, anticoagulation/ antiplatelet treatment for congenital cardiac disease, and ventricular shunt overdrainage. 4 As a result, pediatric chronic subdural hematomas are often identified in infants and young children. Less common etiologies include neoplastic disease and arachnoid cysts, which can affect pediatric patients of any age.…”

mentioning

confidence: 99%