Toddler with repeated fall frequently visiting hospital presented with acute subdural hematoma on readmission with ultra-rapid evolution: surgical management strategy

Repetitive fall producing head injury in children may lead to development of intracranial hematoma. The course of evolution may be rapid in case of repeated fall due to induction of sub-clinical coagulopathy caused by repetitive cranial injury. The awareness of such possibility is highly desired among the pediatrician and neurosurgeon and emergency team and quick diagnosis and pertinent imaging study is of immense value and appropriate surgical management for prompt and expediting the evacuation of intracranial hematoma evacuation should be attempted to preserve good neurological outcome. Authors reports a case, who had rapid neurological worsening, managed surgically with good neurological outcome, further various surgical management options along with pertinent literature are briefly reviewed.

[1]  B. Sharma,et al.  Traumatic Posterior Fossa Extradural Hematoma: Experience at Level I Trauma Center , 2018, Asian journal of neurosurgery.

[2]  G. Satyarthee Ideally, How Early Should Cranioplasty Be Performed-Days, Weeks, or Months Following Decompressive Craniectomy Surgery to Label as "Optimal Early Cranioplasty"? Big Enigma. , 2018, World neurosurgery.

[3]  H. Alvis-Miranda,et al.  Craniocerebral Gunshot Injuries; A Review of the Current Literature. , 2016, Bulletin of emergency and trauma.

[4]  R. Pandey,et al.  Decompressive craniectomy in traumatic brain injury: A single-center, multivariate analysis of 1,236 patients at a tertiary care hospital in India. , 2015, Neurology India.

[5]  D. Agrawal,et al.  Emergent Burr Hole Drainage of Traumatic Acute Subdural Hematoma with Drain Placement in Preexisting Coagulopathy Showing Rapid Neurological Deterioration: A Novel Technique , 2015, Indian Journal of Neurotrauma.

[6]  T. Sakamoto,et al.  Results of single burr hole drainage for acute subdural hematoma with non-reactive pupil. , 2012, Turkish Neurosurgery.

[7]  R. Tasker,et al.  Epidemiology of traumatic brain injury in children receiving intensive care in the UK , 2005, Archives of Disease in Childhood.

[8]  S. Defoort-Dhellemmes,et al.  Accidental and nonaccidental head injuries in infants: a prospective study. , 2005, Journal of neurosurgery.

[9]  L. Kramer,et al.  Acute neuroradiologic findings in young children with inflicted or noninflicted traumatic brain injury , 2000, Child's Nervous System.

[10]  Gerry Leisman,et al.  Biomechanics of head injury. , 1990, The International journal of neuroscience.

[11]  W. Ball,et al.  Radiographic characteristics of skull fractures resulting from child abuse. , 1987, AJR. American journal of roentgenology.

[12]  B. M. Vance Ruptures of surface blood vessels on cerebral hemispheres as a cause of subdural hemorrhage. , 1950, A.M.A. archives of surgery.