A case of subdural hematoma associated with biliary atresia who underwent urgent evacuation of hematoma and external decompression and had a good prognosis

Abstract

The most common cause of intracranial hemorrhage in infants is extrinsic factors, including child abuse; however, there are rare cases of intracranial hemorrhage caused by endogenous diseases. In cases of intracranial hemorrhage with a causative endogenous disease, prognosis can often be poor unless appropriate treatment is performed that take into account the causative endogenous disease by appropriately distinguishing it from extrinsic causes.

A 51-day-old infant was admitted to our hospital due to vomiting and decreased activity. Cranial computed tomography (CT) revealed subdural hematoma (SDH). Emergency evacuation of the hematoma and external decompression were performed. Although the possibility of child abuse was considered, as a result of close examination, it was revealed that SDH was caused by vitamin K deficiency due to biliary atresia (BA). After performing Kasai operation, we performed elective cranioplasty. SDH in infants are often due to trauma, especially child abuse, but there is the possibility that a certain proportion of SDH are due to endogenous diseases. Therefore it is important to provide treatment with a multifaceted perspective. In addition, detailed medical examination is required to prevent patient deterioration into serious conditions.