Abstract

Subdural hematomas with mass effect and midline shift are typically offered urgent surgical evacuation. The authors report a 6-month-old baby who was referred for macrocephaly and found to have a large subdural hematoma with midline shift. Given her lack of symptoms and normal neurological examination, the patient was observed without neurosurgical intervention. She remained asymptomatic, and serial brain imaging showed progressive decrease of the subdural hemorrhage and complete resolution of midline shift. This case is presented to alert neurosurgeons that observation of a large subdural hematoma may rarely be appropriate in babies with open fontanelles.

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