Objective: Subdural haematomas constitute a major cause of morbidity and mortality in children under 2 years old. We aimed to describe the clinical presentation, therapeutic options, and sequelae of subdural haematomas. Method: A chart review of 138 records of patients aged 2 to 24 months hospitalised for treatment of a subdural haematoma (SDH) in the PaediatricNeurosurgery Department of the Timone Children’s Hospital between 1996 and 2006. We included 107 cases with complete medical records. Data collected included sociodemographics, the circumstances of occurrence, personal history, the clinical presentation, fundoscopic and imaging findings, the therapeutic modalities, and patient outcomes. Descriptive statistics were used to present the proportion of distinctive characteristics. Results: Of the 107 children included, 83 (78%) were boys, their average age was 6 months and 99 (93%)were less than 1 year old. About 12% of patients had a history of epilepsy. Suspected child abuse was reported in 31% and was confirmed in 17% of patients. Acute SDH was reported in 21% and chronic SDH in 79% of patients. Impaired consciousness (78%) and convulsions (49%) were the main symptoms reported. The main clinical signs were a bulging fontanel (69%) and an increased head circumference (64%). The commonest fundoscopic finding was a retinal haemorrhage in 48% of patients. The main treatment options included a conservatory treatment (7%), transfontanellar puncture (36%), external subdural diversion (42%), subdural-peritoneal diversion(73%), trephine (8%) and flap (7%) craniotomy. Recurrences were recorded in 6% of patients. Epilepsy (4%) was the main sequelae. Only a single death (1%) was recorded at the end of the study. Conclusion: Childhood SDH is a condition often linked to abuse in children aged 2 to 24 months in this setting. Subdural peritoneal diversion is the main therapeutic method used in this retrospective study. Despite advances in therapeutic techniques, SDH leaves children with sequelae notably epilepsy.
subdural haematoma, therapeutic methods- sequelae
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