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Chronic non-traumatic recurrent subdural hematoma in children: A case report

Abstract

Introduction: Chronic subdural hematoma (CSDH) is caused by trauma to the bridging veins. CSDH mainly occurs in the elderly but can happen in children in rare cases.  The incidence of CSDH in pediatric and infant population are 20-25/100.000 and 12/100.000. Several etiologies for CSDH in infancy, including birth injury, fever, child abuse, and coagulopathy have been reported. On computed tomography (CT) scan, CSDH appears as a hypodense lesion in subdural space. Certain conditions require burr hole drainage for clot evacuation.

Case presentation: A 13-year-old boy presented with a complaint of chronic headache in the last three months which worsened one day before coming to the hospital. The headache felt like a squeezing sensation and was not relieved with rest. On laboratory examination, we found prolonged prothrombin time (PT) and activated partial thromboplastin time (aPTT). On CT scan, there was CSDH in the right parietooccipital region, acute SDH in the left parietal, and right parasagittal. The patient underwent a burr hole drainage. Two weeks before, the patient came to the emergency department with the same complaint.  PT and APTT levels were in the normal range and CSDH in the right frontoparietooccipital region was seen on CT examination. The neurosurgeon decided to perform burr hole drainage. The patient made a good recovery immediately after the surgery and there was no recurrence of his symptoms during the six-month follow-up.

Conclusion: CSDH often happens in the elderly but can occur in children in rare cases. CSDH in children can be caused by fever or bleeding disorders. Spontaneous CSDH in children which recur several times exhibits a poor prognosis. Burr hole drainage is required to remove the clot.

Keywords: chronic subdural hematoma, pediatric, recurrent

How to Cite

Hakim, I. A., Azkia, E. S., Agustina, N. N., & Octavian, A. E. (2023). Chronic non-traumatic recurrent subdural hematoma in children: A case report. Indonesian Journal of Neurosurgery, 6(3), 39–41. https://doi.org/10.15562/ijn.v6i3.243

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Irfaanstio Akbar Hakim
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Ema Shofiana Azkia
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Nenden Nursyamsi Agustina
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Aditya Eka Octavian
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