Bergene E, Tira AE, Hussen E, Smith CJ, Fetle YT. Neonatal Spontaneous Bilateral Posterior Fossa Chronic Subdural Hematoma and Obstructive Hydrocephalus with a Successful Outcome: A Case Report.
Int Med Case Rep J 2023;
16:351-355. [PMID:
37313348 PMCID:
PMC10259532 DOI:
10.2147/imcrj.s413163]
[Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/14/2023] [Accepted: 06/03/2023] [Indexed: 06/15/2023] Open
Abstract
Background
Chronic supratentorial subdural hematoma is uncommon in neonates but accounts for most neurosurgical procedures in neonatal age. However, its occurrence in the posterior fossa is extremely rare. It can be caused by instrumental delivery, coagulation abnormality, hypoxic insult, and various structural abnormalities. Furthermore, spontaneous onset has been reported only in a few case reports.
Case Presentation
A twenty-nine-day-old male neonate presented with failure to suck for three days duration associated with vomiting. Imaging showed bilateral posterior fossa chronic subdural hematoma and obstructive hydrocephalus. Bilateral burrhole craniostomy and hematoma evacuation was done which resulted in an excellent outcome.
Conclusion
Posterior fossa chronic subdural hematoma is extremely rare in the neonatal period. It can be caused by various possible etiologic agents; however, rarely it can occur spontaneously. Management with suboccipital burrhole craniostomy and hematoma evacuation can result in a good outcome. Intraoperative monitoring and management with an experienced anesthesiology team are indispensable for a good outcome.
Study Setting
Pediatrics neurosurgery ward, St Peter's Comprehensive Specialized Hospital, Addis Ababa, Ethiopia.
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