Infantile Chronic Subdural Hematoma Secondary to Brain Atrophy

Abstract

Chronic subdural hematoma (CSH) may develop in infants as a result of some accompanying circumstances of brain atrophy. A six-month-old boy with mental and motor retardation and increased head circumference was admitted in our hospital. His head circumference was over 97 percentile. Hypotonic and hypoactive baby couldn’t hold his head and wasn’t interested in surrounding enviroment. He had a history of aspiration pneumonia with no history of head trauma. MRI showed acute elements over chronic subdural hemorrhage spread almost all over the supratentorial area with severe cerebral atrophy. The brain volume was 95.252 mm 3 and it was around 1/6-1/8 of normal volume. It is thought that, chronic subdural hematoma was developed due to cerebral atrophy as a cascade started with chronic hypoxia and resulted as an increase in the head circumference and panhypopitruitism. After 10 days of subdural drainage, subduroperitoneal shunt was placed’. At the end of second month, head circumference stopped increasing, the patient could hold his head and started to be partially interested in the surrounding objects, however the change in the brain volume was not significant. Cognitive and motor functions progress very rapidly in the first two years of life. Early evacuation of CSH has a positive effect on prognosis and most commonly used method is subduraperitoneal shunt insertion.