Subdural hematoma in childhood. Considerations about twenty cases and review of the literature

Background: Subdural hematoma is defined as a clot between dura-mater and arachnoid spaces due to trauma, infectious diseases or bleeding disorders. In infancy, subdural hematoma is a clinical syndrome that, although relatively constant in its overall features, is often unrecognized with later diagnostic. The subdural hematoma in childhood is more commonly seen in the child of the three weeks of life or more. Clinical features depend on patient’s age, the hematoma’s site and its length. Computed tomography and magnetic resonance are the best methods. Aim: 1) to identify the sex, age, causes and computed tomography findings in patients with subdural hematoma; 2) to analyse the results of the treatment. Material and Methods: This study is retrospective. Twenty children under fifteen years old were studied at João Alves Filho Hospital (Aracaju – Sergipe – Brazil). The period was 1995, may to 2004, june. Results: Twelve (60 por ciento) children were male and eight (40 por ciento) female. Children’s age ranged from two days to fourteen years old. The most common causes were fall, car collision, trampling, delivery trauma and fight. Computed tomography was important for diagnosis and treatment. The clinical treatment was done in thirteen patients. Fifteen (67 por ciento) patients had good recovery and five (33 por ciento) died. Conclusion: 1) the male children were more affected; 2) the principal age was 6 to 12 years old; 3) the most common cause was fall; 4) the main localization in computed tomography was parieto-temporal and 5) 67 por ciento of the patients survived.

Migration of ventriculoperitoneal shunt catheter into the cranium - case report

Shunt migration into the cranium is an uncommon complication of surgical treatment for hydrocephalus. The authors report a case of a 4-months-male child that wanted a ventriculoperitoneal shunt catheter due to hydrocephalus. As a complication of the treatment, the catheter migrated into do cranium. The catheter was removed and a new catheter was fixed in other area. The child has been attended for one year with good development.