Chronic epidural hematoma: Case report and literature review.

Solapas principales

Bentancourt M. 1, Martínez F. 2

 

ABSTRACT

 

            Traumatic brain injury is a pandemic that primarily affects children and young people. Epidural hematoma in young children is rare given the dural adherence to the skull. Hematoma chronification at this age is an even rarer phenomenon. A girl with a chronic epidural hematoma is presented and the literature is reviewed.

Two years and nine months old patient with hydrocephalus diagnosed at birth, who required a ventriculoperitoneal shunt, and a global developmental delay. She falls from the bed fifteen days prior to admission. The parents carried her to hospital after finding a delay in filling the valve. A brain computed tomography and a magnetic resonance were performed, showing an epidural, biconvex, hyperintense image in T1 and T2 with gadolinium enhancement in the periphery. It was interpreted as a chronic epidural hematoma and an evacuation was performed. It was complicated by an infection of the surgical site. 

Chronic epidural hematoma definition varies in the literature with time lapses between 7 and 13 days from trauma to diagnosis. It is associated with low cinematic traumas. It presents with symptoms of high intracranial pressure, neurological deficit or seizures.  On brain computed tomography is seen as an epidural, biconvex image, with a variable density depending on the time of evolution, with enhancement of the dural border after contrast administration. Magnetic resonance imaging can help in case of doubts. Surgery is the treatment. There are no standardized techniques for its treatment but some basic principles, given their rarity. Regardless of the technique chosen, the risk of complications is low. The prognosis is good.

Chronic epidural hematoma is a rare condition, with good prognosis if it is diagnosed and treated early.

 

Key Words:Chronic epidural hematoma, epidural hematoma

 

 


 

  1.  Residente de Neurocirugía
  2. Profesor Agregado de Neurocirugía de la Cátedra de Neurocirugía del Hospital de Clínicas, Facultad de Medicina, Universidad de la República

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