Management of subdural hygroma in infants and children

Abstract

Users have the right to read, download, copy, distribute, print, search, or link to the full texts of articles under the following conditions: Creative Commons Attribution-Share Alike 4.0 International Public License (CC BY-SA 4.0).

Symptomatic Subdural Hygroma Following Acinetobacter Meningitis in an Infant

“…Subdural hygroma, also named “fluid collection” or “effusion” by various authors [ 1 , 5 , 6 ], is defined as an accumulation of CSF in the subdural space and may be secondary to ventricular shunting (the most common cause), brain injury, meningitis, or may be idiopathic, as a result of abnormal CSF absorption and rupture of the outer arachnoid membrane [ 1 , 2 ]. Postmeningitis subdural collection (a term that authors often wrongly use as a synonym of subdural empyema [ 7 ]) is a common complication of bacterial meningitis in infancy [ 8 ].…”

“…Subdural hygromas compress the underlying brain, which may be responsible for not only neurological symptoms but also developmental anomalies in pediatric age. Furthermore, this condition, opposing to other similar collections (such as benign peri-cerebral, subdural, extra-axial, or subarachnoid fluid collections of infancy), does not resolve spontaneously [ 5 ] and may develop into subdural hematomas (usually about one month after the appearance of the hygroma) [ 6 ]. The main symptoms are increased intracranial pressure, macrocrania, delayed development, hemiparesis, seizures, and decreased consciousness [ 1 , 6 ].…”

“…The decision to adopt a conservative or surgical management is still controversial. Most subdural hygromas resolve spontaneously, thus the decision regarding the type of management is guided by clinical presentation and imaging findings [ 2 ], including the size of the lesion and its progression [ 5 , 6 ]. The most common indications for surgery are persistent or recurrent fever, seizures, and bulging fontanelle [ 7 ].…”