Abstract
The patient was an 11-month-old boy and a first-born twin. The second-born twin was breastfed, whereas the first-born twin was fed baby formula. Unlike second-born twins, first-born twins sometimes have developmental delays of unknown cause. The patient was emergently transported to our hospital after experiencing a sudden impaired consciousness while his mother was attending to her children by herself. Upon arrival, the patient’s Glasgow Coma Scale was E1V2M1, but head MRI showed no obvious abnormalities. However, frequent convulsions began on the third day, and on the sixth day, head MRI revealed an acute subdural hematoma, and diffusion-weighted imaging showed a bright tree appearance in the bilateral temporo-occipital lobes. An ophthalmological examination revealed a retinal hemorrhage. The patient had an infantile head injury with a biphasic clinical course and late reduced diffusion because of how he was being nurtured and the presence of a retinal hemorrhage based on the findings of an ophthalmologic examination. Steroid pulse therapy was administered, and the patient recovered clinically to their pre-illness condition. However, brain MRI on the 33rd day of hospitalization revealed polycystic changes.
