新生児後頭蓋窩硬膜下血腫の脳エコー像

抄録

We describe the case of a patient who was born through vacuum extraction at a gestational age of 40 weeks. Birth weight was 2714 g and Apgar score was 9. On the day of birth (Day 1), she was transferred to our neonatal intensive care unit due to poor feeding, frequent vomiting, and cyanosis. Echo imaging of the brain showed a hypoechoic area in the left posterior fossa, obstruction of the cerebral aqueduct due to anterior displacement of the cerebellum, and dilation of the cerebral ventricles. Computed tomography (CT) of the head indicated the presence of a high-density lesion in the same fossa, and posterior fossa subdural hematoma was therefore diagnosed. She was then transferred to another hospital for surgery. Oral feeding improved after surgical removal of the hematoma, and she was discharged on day 17. Early diagnosis of posterior fossa subdural hematoma is important, as the condition of affected patients may rapidly deteriorate, potentially resulting in death. Studies have reported the difficulty of detecting hematomas in the posterior fossa using brain echo imaging, as well as the utility of head magnetic resonance imaging and CT for definitive diagnosis. However, based on the findings in this case, we believe that the presence of a hypoechoic area in the posterior fossa, displacement of the cerebellum, and ventricular dilatation on brain echo imaging are essential in making a diagnosis of posterior fossa subdural hematoma.