• Sangkae Chamnanvanakij, Nancy Rollins, and Jeffrey M Perlman.
• Department of Pediatrics, UT Southwestern Medical Center, Dallas, Texas 75235-9063, USA.
• Pediatr. Neurol. 2002 Apr 1; 26 (4): 301-4.

AbstractSubdural hematomas are uncommon in term infants. The study objectives were to evaluate risk factors for and clinical significance of small subdural hematomas observed on computerized tomography. During a 3-year period, 26 near-term and term nonasphyxiated infants were found to have a subdural hematoma on computed tomography. Clinical indications for computed tomography were respiratory symptoms in 15 infants and neurologic symptoms in 10 infants; one infant had a skull fracture. Subdural hematomas were less than 3-mm maximum transverse dimensions in all infants: location was infratentorial (n = 7), supratentorial (n = 7), and in both sites (n = 12). Four infants also had evidence of edema and hemorrhage within the anterior temporal lobe. Delivery was vaginal in 25 of 26 infants, and forceps were used in 13 (50%) infants. Twenty-five infants were managed expectantly; one infant underwent surgical elevation of a depressed skull fracture. No infant required surgical evacuation of the subdural hematoma. At discharge, nine infants with subdural hematoma exhibited an abnormal examination, i.e., mild hypotonia (n = 7) and Erb's palsy (n = 2). The clinical syndrome attributed to subdural hematoma was most often a subtle clinical problem. The presence of subdural hematoma documented by computed tomography is not necessarily always indicative of birth trauma and may occur as sequelae of an otherwise uncomplicated delivery.

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