2018 Volume 23 Issue 1 Pages 17-23
Acute subdural hematoma (ASDH) in children indicates different pathophysiology from adult ASDH. Children with ASDHs who were injured by minor head trauma occasionally show unfavorable outcomes. A clarification of the clinical factors related to the outcomes of child ASDH could lead to improved prognoses of child ASDH patients. This study was conducted to evaluate predictors of unfavorable outcomes in child ASDH patients and to investigate clinical factors affecting the predictors of unfavorable outcomes. The cases of the children aged ≤ 6 years old with ASDH admitted to Tokai University Hospital from 2000 to 2016 were retrospectively evaluated. During the 17‒year period, 70 children with ASDH were treated. Unfavorable outcomes occurred in 21 children (30%). A multivariate analysis revealed the occurrence of ischemic lesions on neuroimages (cerebral infarction following ASDH: CIASDH) as the only predictor for unfavorable outcomes (p＜0.05). Clinical factors related to the occurrence of CIASDH were convulsion, consciousness disturbance at admission, and a midline shift ≥ 3 mm on computed tomography (CT) (p＜0.05). The occurrence of CIASDH gravely affected the outcomes of children with ASDHs. When a child with an ASDH shows convulsion, consciousness disturbance, and/or a midline shift on CT, the possibility of a CIASDH should be taken into account in the treatment of the child.
