A life threatening problem in infants: supratentorial epidural hematoma

Traumatic epidural hematoma (EDH) represents a rare head injury complication in infants.Its diagnosis can be quite challenging because its clinical presentation is usually subtle and nonspecific.Authors present a study on 30 infants with epidural hematoma (EDH) admitted in the Pediatric Department of Neurosurgery of the ‘Bagdasar–Arseni’ Clinical Hospital in the period of 1990–2007 (17 years).The most common symptom was irritability, which occurred in 16 cases (53.3%), of our patients. Pallor in all cases (100%) and subgaleal hematoma in 20/30 (66.6%) of the patients. These were the most common clinical signs that occurred upon admission; both of them represent signs of significant clinical importance. Surgical evacuation via craniotomy was required in 26/30 (86.6%) of our patients, while 4/30 (13.3%) of the patients were managed conservatively. The mortality rate was 6.6% in our series, whilst the long–term morbidity rate was 3.3%. EDH in infants represents a life–threatening complication of head injury, which requires early identification and prompt surgical or conservative management depending on the patient's clinical condition, the size of EDH, and the presence of a midline structure shift on the head's CT scan.