Subdural hematomas of the posterior fossa in normal-weight newborns

Hernansanz, José; Muñoz, Fernando Miralles; Rodríguez, Daniel Lahoz; Soler, Concepción López; Principe, Carlos

doi:10.3171/jns.1984.61.5.0972

Cited by 27 publications

(10 citation statements)

References 9 publications

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“…Posterior fossa subdural hemorrhages have been described in a number of neurosurgical publications [4, 8, 9, 10, 15]. In one review of 13 such infants, 7 (54%) followed forceps deliveries, and 1 (8%) a vacuum delivery (the remaining 5 followed unassisted vaginal deliveries) [9].…”

Section: Discussionmentioning

confidence: 99%

“…In one review of 13 such infants, 7 (54%) followed forceps deliveries, and 1 (8%) a vacuum delivery (the remaining 5 followed unassisted vaginal deliveries) [9]. …”

Section: Discussionmentioning

confidence: 99%

“…While cranial injuries are well-recognized complications of delivery, to date, only small series have been described [2, 4, 5, 6, 7, 8, 9, 10, 11, 12, 13, 14, 15, 16, 17, 18, 19, 20]. To better understand the demographics, types of cranial injuries, presenting features, radiographic appearance and management of these birth injuries, and to further investigate what relationship, if any, exists between cranial birth injuries and various maternal and/or neonatal factors and/or modes of delivery, we reviewed our experience with these injuries in term neonates and compared them with a control group of term neonates without cranial injury.…”

Section: Introductionmentioning

confidence: 99%

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Cranial Birth Injuries in Term Newborn Infants

Pollina¹,

Dias²,

Li³

et al. 2001

Pediatr Neurosurg

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While cranial birth injuries in term infants are well recognized, to date, only small case series have been described. In an attempt to further define the spectrum of cranial birth injuries, we analyzed 41 consecutive cranial birth injuries at our institution over the period 1991–1998. The most common clinical presentations were apnea (39%) and seizures (37%). Average Apgar scores were 5.7 at 1 min and 7.3 at 5 min; 54% of infants had abnormally low Apgar scores at 1 min and 31% had abnormally low scores at 5 min. The most common intracranial lesion was subdural hemorrhage, present in 73% of infants; most had either a tentorial (57%) and/or interhemispheric (50%) location. Operative treatment was required in 5 infants (12%). Two of the 41 infants (4.8%) died. The study group was compared with a control group of 63 randomly selected births without cranial injury. Using a stepwise logistic regression model, independently significant variables included neonatal birth weight, Apgar scores at 1 and 5 min and mode of delivery. Compared with the controls, the study group had a significantly higher incidence of forceps and/or vacuum deliveries. Combining vacuum, forceps and urgent cesarean section deliveries together as ‘urgent’ and elective cesarean and spontaneous vaginal deliveries as ‘nonurgent’, we could find no significant differences between these two groups. Our data conflict with those of Towner et al. [N Engl J Med 1999;341:1709–1714], and suggest that the method of assisted delivery, rather than the urgency of the delivery or dysfunctional labor per se, is a more important variable in cranial birth injuries.

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Section: Discussionmentioning

confidence: 99%

“…In one review of 13 such infants, 7 (54%) followed forceps deliveries, and 1 (8%) a vacuum delivery (the remaining 5 followed unassisted vaginal deliveries) [9]. …”

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

See 1 more Smart Citation

Cranial Birth Injuries in Term Newborn Infants

Pollina¹,

Dias²,

Li³

et al. 2001

Pediatr Neurosurg

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“…It is frequently observed after a spontaneous vaginal delivery (Fig 7). 45 These dilated blood vessels are damaged due to elevated venous pressure in the head and neck during the labor and delivery process; the presence of a tight nuchal cord may also contribute. 46 Injuries are readily apparent on physical examination as bright red patches present in the iris.…”

Section: Injury To the Eyementioning

confidence: 99%

Part 1

Parker

2005

Advances in Neonatal Care

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The Joint Commission on Accreditation of Healthcare Organizations (JCAHO) Sentinel Event Alert from July 21, 2004 states that there have been 47 cases of birth trauma-related perinatal death or permanent disability reported for JCAHO review since 1996. This report clearly illustrates the importance of birth trauma in clinical practice for neonatal and perinatal nurses. Estimates suggest that birth trauma occurs in 2% to 7% of all deliveries and is associated with an increase in both mortality and morbidity. Birth trauma to the head may result in minor superficial extracranial injuries, such as caput succedaneum and cephalohematoma, or more serious and potentially life threatening lesions such as subgaleal hemorrhages. The potential for deeper intracranial injury, such as subarachnoid or subdural hemorrhage exists; these may be isolated or associated with skull fractures and/or other extracranial injuries. Injury to the eye, nasal structures, and paralysis of the vocal cords may also result from birth trauma during a difficulty delivery. Part 1 of this 2-part article will focus on birth injuries to the head and face. Part 2 of the series will review more systemic birth injuries that may involve abdominal organs, the spine and skeletal system, and peripheral and facial nerves.

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“…Tentorial damage is often associated with primary neonatal posterior fossa subdural haemorrhage (PFSDH), a rare variant of newborn intracranial bleeding, the major cause of which remains a difficult deliveryl0, 17,18,22,30,31. Three main types of PFSDH exist.…”

Section: Introductionmentioning

confidence: 99%

On the management of neonatal tentorial damage. Eight case reports and a review of the literature

et al. 1990

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From the history of 15 personal patients--8 reported here in extenso--and from 63 patients in the literature with the diagnosis of posterior fossa subdural haemorrhage during life, we discuss the possibility of detecting tentorial damage on computed tomography (CT) and ultrasound (US) scan. The association of a (peri)cerebellar haemorrhage with peritentorial bleeding around the straight sinus and a subdural haemorrhage between both occipital cerebral lobes is suggestive of tentorial laceration(s). Both coronal CT scan and sagittal US scan are very helpful in locating these haemorrhages near the falco-tentorial junction. The conservative management of one of our infants with very extensive but asymmetric posterior fossa haemorrhage, leading to resorptive hydrocephalus, is compared with both surgical and conservative treatment of patients from the literature. Two reasons that warrant neurosurgical intervention are: life-threatening brain-stem compression--as in one of our own patients--and acute obstructive hydrocephalus. Craniotomy of the posterior fossa within the neonatal period does not prevent later-onset resorptive hydrocephalus. The communicating nature of this latter process is adequately demonstrated by lumbar isotope cisternography. Finally, neonatal posterior fossa subdural haemorrhage is one of the many causes of cyst-like structures behind the cerebellum.

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Subdural hematomas of the posterior fossa in normal-weight newborns

Cited by 27 publications

References 9 publications

Cranial Birth Injuries in Term Newborn Infants

Cranial Birth Injuries in Term Newborn Infants

Part 1

On the management of neonatal tentorial damage. Eight case reports and a review of the literature

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