Acute subdural hematomas in childhood

Objectives: to evaluate incidence, aetiology, clinic caractheristics and th erapy of acute subdural hematomas in childhood. Methods: we studied retrospectively 14 children with acute subdural hematom a, admitted to the Neurosurgery Unit and the Pediatric Intensive Care Unit of Gemelli Hospital in Rome. We examined data about age, sex, head injury aetiology, symptoms, therapy a nd outcome. The neurologic status of the patients was evaluated using the G lasgow Coma Scale (GCS). Results: four patients were less that? one year old. In 13 children (93%) t he hematomas were caused by a traumatic event. The most frequent symptom wa s an altered mental status. ln 69% of the cases hematoma was associated to cerebral contusions, while in 3 patients a skull fracture was present, too. In 9 cases (GCS 8) the hematoma was neuro-surgically removed while the oth er. patients, which had GCS 10, were treated only farmacologically. Four ch ildren died; out of the survival 10 patients, 2 have a severe disability, 5 present a mild disability, 3 have a good recovery. Conclusions: in our experience the neurologic condition at the admittance i s the most significant prognostic factor. As described in literature, the c erebral contusions determine a worsening in prognosis. Other factors, like age or therapeutic management do nor have a significant role, in our experi ence.