• J Emerg Med · Apr 2014

    Case Reports

    Asymptomatic Chronic Epidural Hematoma in a Child As a Result of Extracranial Decompression.

    • Elif Yaka, Murat Pekdemir, Ahmet Kama, Hasan Tahsin Sarısoy, and Serkan Yılmaz.
    • Department of Emergency Medicine, Faculty of Medicine, Kocaeli University, Umuttepe, Kocaeli, Turkey.
    • J Emerg Med. 2014 Apr 1;46(4):482-5.

    BackgroundEpidural hematoma (EDH) in children is a diagnostic challenge due to its nonspecific clinical presentation. Asymptomatic chronic epidural hematoma is a very rare entity. Reports of spontaneous decompression into the subgaleal spaces are limited with acute epidural hematomas in the literature.ObjectiveWe report a child presenting with chronic epidural hematoma at 15 days after a head trauma. She remained asymptomatic, owing to spontaneous decompression via a skull fracture. We intend to remind emergency physicians to be alert about epidural hematomas in asymptomatic children in the presence of a history of, even minor and distant, trauma.Case PresentationAn 8-year-old girl presented to the Emergency Department with a swelling in the right parietal region. She had fallen at the playground and struck her head on the ground 15 days prior. Computed tomography showed a mixed-density subacute-chronic parietal epidural hematoma with a linear fracture overlying it. There was no evidence of midline shift or ipsilateral ventricular compression.ConclusionAn initially minimal but expanding EDH in a child can remain asymptomatic even in the later phases, owing to the spontaneous decompression through a skull fracture.Copyright © 2014 Elsevier Inc. All rights reserved.

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