Traumatic acute giant epidural hematoma in a hydrocephalic shunted child

Extradural hematoma (EDH) is considered to be a rare complication of head t rauma in children, and represents a serious and urgent pathology from which complete recovery can be expected if specialized treatment is instituted i n time, in this article, the authors report the potential danger to a hydro cephalic shunted child who was apparently asymptomatic at the time of hospi tal admission with a mild head injury and developed an EDH of venous origin . This child had a rapid (time interval from injury to decerebrate posture of about 2 h), atypical (remained asymptomatic most of the time until abrup tly deterioration) and fatal course, stressing the importance of early diag nosis and rapid therapy in order to avoid the death of the patient, The aut hors discuss the role of the ventriculoperitoneal shunting system in the la ck of clinical symptoms associated with the presence of a giant EDH and a r apid and fatal course, and stress the importance of computed tomographic (C T) scanning in these patients, even if they are asymptomatic, If a skull fr acture is suspected, a CT scan must be performed without delay. Copyright ( C) 2000 S. Karger AG, Basel.