Epidural Hematoma Communicating with Cephalhematoma in a Neonate

Aoki, Nobuhiko

doi:10.1227/00006123-198307000-00011

Cited by 26 publications

(11 citation statements)

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“…Although there are anecdotal reports in the literature on needle aspiration of intracranial hematoma, the cases presented had extraaxial hemorrhages, without intra-axial components (►Table 2). [5][6][7][8]11,12 In 1983, Aoki 8 reported the association of an epidural hematoma with a depressed skull fracture and in his report, he stated that the successful management of this condition was achieved by aspiration of the liquefied hematoma rather than surgical removal. Later on, Negishi et al 11 and Yamamoto et al 12 reported further successful management of newborn infants with an extra-axial epidural hemorrhage with the aspiration technique and the latter stated that surgical procedures should be attempted only if aspiration turns out to be ineffective.…”

Section: Discussionmentioning

confidence: 99%

“…However, data on percutaneous needle aspiration is limited to a few cases with an extra-axial epidural or subarachnoid hemorrhage. 3,[5][6][7][8][9][10] The aim of this study was to illustrate the use of ultrasound-guided percutaneous needle aspiration in eight newborn infants with a large extra-axial hemorrhage associated with a parenchymal hemorrhage causing a midline shift and to review the literature on this method.…”

Section: Introductionmentioning

confidence: 99%

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Bedside Ultrasound-Guided Percutaneous Needle Aspiration of Intra- and Extra-Axial Intracranial Hemorrhage in Neonates

et al. 2018

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Intracranial hemorrhage is an important cause of brain injury in the neonatal population and bedside percutaneous needle aspiration has emerged as an alternative due to the major risks that can be caused by standard neurosurgical decompression. We aimed to assess the effectiveness of this minimally invasive bedside technique and conducted a retrospective analysis of all newborn infants with a large extra-axial hemorrhage associated with a parenchymal hemorrhage causing a midline shift, managed at three academic centers over a 15-year period. Collected data included clinical history, laboratory results, review of all imaging studies performed, and neurodevelopmental follow-up. Eight infants (3 preterm and 5 full-term) presented on day 1 to 2 with seizures ( = 6) and apneas ( = 5), signs of increased intracranial pressure ( = 4), and coning ( = 1). Risk factors were present in six. Cranial ultrasound and computed tomography showed a midline shift in all; two infants showed status epilepticus on amplitude-integrated electroencephalography with complete resolution after the procedure. Between 7 and 34 mL could be aspirated associated with a decrease in the midline shift as seen by ultrasonography performed during the puncture. No complications were seen related to the procedure and none of the infants required further acute neurosurgical intervention. On follow-up, three had mild sequelae, including motor coordination problems ( = 1) and hemianopia ( = 2); none developed cerebral palsy or postneonatal epilepsy. Neonates, presenting with severe symptoms, can be managed successfully using ultrasound-guided needle aspiration and this minimally invasive bedside method should be kept in mind before performing neurosurgical decompression.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Bedside Ultrasound-Guided Percutaneous Needle Aspiration of Intra- and Extra-Axial Intracranial Hemorrhage in Neonates

et al. 2018

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“…However, the authors never recommend a time frame for evacuation. Other reports have shown the benefit of cephalohematoma aspiration as a means of evacuating a communicating epidural hematoma in newborns [7,8,9,10,11,12]. …”

Section: Discussionmentioning

confidence: 99%

Early Surgical Intervention for a Large Newborn Cephalohematoma

2016

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Cephalohematomas in newborns are often managed nonsurgically and resolve within the first month of life. In cases of large hematomas (>7 cm) with delayed resorption and persistence over 4 weeks, these masses can often lead to complications of calcification, infection, or hyperbilirubinemia. We report a case of a 14-day-old child with a persistent, large, noncalcified cephalohematoma. After observation alone showed that the cephalohematoma increased in size, 100 ml of old blood was surgically evacuated on day 15 of life. The procedure required a small 1-cm incision and, unlike most large cephalohematomas evacuated after 1 month of observation, there were no signs of skull-deforming calcification observed. This case report presents the earliest evacuation of large noncalcified cephalohematomas in newborns ever reported in the literature, and suggests benefits of early surgical evacuation before 1 month of life.

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“…When clinical symptoms are mild and an acute epidural hematoma communicates with a cephalohematoma, the liquid hematoma can be removed by cephalohematoma aspiration. 16,17,21,24 However, a clotted hematoma cannot be removed by aspiration. Neonate skull strips can be bent manually.…”

Section: Discussionmentioning

confidence: 99%

“…There are only a few reported cases of neonatal acute epidural hematoma related to delivery. 4,6,9,[21][22][23][24] In particular, the reports of epidural hematomas after falls following delivery are very rare. 4,10,20,23 The meningeal artery is less developed in a neonate because of the shallow groove on the skull.…”

Section: Introductionmentioning

confidence: 99%

Endoscopic Removal of Neonatal Acute Epidural Hematoma via Strip-Bending Osteoplastic Craniotomy. Technical Note

Nakatogawa

Tanaka

Inenaga

et al. 2015

J Neurol Surg A Cent Eur Neurosurg

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We present a rare case of an acute epidural hematoma extending through a skull fracture into a cephalohematoma in a neonate. The epidural hematoma was caused by a fall after delivery. The neonate remained neurologically asymptomatic. A computed tomography scan 12 days after delivery showed the large-volume epidural hematoma with midline shift. We performed a strip-bending osteoplastic craniotomy and removed the epidural hematoma and external cephalohematoma under neuroendoscopic control. This is the first reported case of an acute epidural hematoma in a neonate treated successfully neuroendoscopically via a strip-bending craniotomy.

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Epidural Hematoma Communicating with Cephalhematoma in a Neonate

Cited by 26 publications

References 0 publications

Bedside Ultrasound-Guided Percutaneous Needle Aspiration of Intra- and Extra-Axial Intracranial Hemorrhage in Neonates

Bedside Ultrasound-Guided Percutaneous Needle Aspiration of Intra- and Extra-Axial Intracranial Hemorrhage in Neonates

Early Surgical Intervention for a Large Newborn Cephalohematoma

Endoscopic Removal of Neonatal Acute Epidural Hematoma via Strip-Bending Osteoplastic Craniotomy. Technical Note

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