Subdural hematomas in young children: clinical and electrophysiological features

Subdural hematoma is a sufficiently rare, but serious pathology of the brain in infants, which can lead to severe neurological deficit or result in death. Subdural hematomas are detected in 20–25 per 100,000 children under 1 year. A retrospective analysis of autopsy material revealed that subdural hematomas were diagnosed in 72% of children who died before the age of 5 months from intracranial hemorrhage. According to localization, subdural hematomas are divided into supra- and subtentorial, mainly associated localization, which are located along the tent of cerebellum and sickle of the brain, mainly. The main mechanism of development of subdural hematomas is associated with the rupture of the bridge veins of the subdural space as a result of their tension, both traumatic etiology and nontraumatic brain damage, accompanied by progressive cerebral atrophy. It is believed that perinatal hypoxic-ischemic brain damage is one of the leading etiological factors of developed subdural hematomas in young children. In addition, the formation of subdural hematomas in young children can be observed with intraamniotic infections, congenital fermentopathies, and above all, in children with aciduria. In some infants, subdural hematomas occur without clinical manifestation, but in most cases are accompanied by the development of neurological disorders, both in acute and in distant periods. In the main, subdural hematomas in the acute period manifest with focal convulsions with secondary generalization of seizures, behavioral disturbances, respiration, and symptoms of intracranial hypertension. During the formation of chronic subdural hematoma, development of structural epilepsy (up to 20%), microcephaly, impaired psychomotor development is observed. In 55% of young children with acute subdural hematomas, the formation of chronic subdural hematomas is observed.