Hwang S K, Kim S L
Department of Neurosurgery, Kyungpook National University, School of Medicine, Korea.
Childs Nerv Syst. 2000 Sep;16(9):590-4. doi: 10.1007/s003810000312.
An infantile head injury has unique features in that infants are totally helpless and dependent on their parents, and biomechanical characteristics of the skull and brain are very different from those of other age groups. The authors reviewed a total of 16 infant head injury patients under 12 months of age who were treated in our hospital from 1989 to 1997. Birth head injury was excluded. The most common age group was 3-5 months. Early seizures were noted in 7 cases, and motor weakness in 6. Three patients with acute intracranial hematoma and another 3 with depressed skull fracture were operated on soon after admission. Chronic subdural hematomas (SDHs) developed in 3 infants. Initial CT scans showed a small amount of SDH that needed no emergency operation. Resolution of the acute SDH and development of subdural hygroma appeared on follow-up CT scans within 2 weeks of injury. Two of these infants developed early seizures. Chronic SDH was diagnosed on the 68th and 111th days after the injuries were sustained, respectively. The third patient was the subject of close follow-up with special attention to the evolution of chronic SDH in view of our experience in the previous 2 cases, and was found to have developed chronic SDH on the 90th day after injury. All chronic SDH patients were successively treated by subduro-peritoneal shunting. In conclusion, the evolution of chronic SDH from acute SDH is relatively common following infantile head injury. Infants with head injuries, especially if they are associated with acute SDH and early development of subdural hygroma, should be carefully followed up with special attention to the possible development of chronic SDH
婴儿头部损伤具有独特的特征，因为婴儿完全无助且依赖父母，而且颅骨和大脑的生物力学特征与其他年龄组有很大不同。作者回顾了1989年至1997年在我院接受治疗的16例12个月以下的婴儿头部损伤患者。排除出生时的头部损伤。最常见的年龄组是3至5个月。7例出现早期癫痫发作，6例出现运动无力。3例急性颅内血肿患者和另外3例颅骨凹陷骨折患者入院后不久接受了手术。3例婴儿发生了慢性硬膜下血肿（SDH）。最初的CT扫描显示少量SDH，无需紧急手术。在受伤后2周内的随访CT扫描中，急性SDH消退并出现硬膜下积液。其中2例婴儿出现早期癫痫发作。慢性SDH分别在受伤后第68天和第111天被诊断出来。鉴于前2例的经验，对第3例患者进行密切随访，特别关注慢性SDH的演变，发现其在受伤后第90天发生了慢性SDH。所有慢性SDH患者均先后接受了硬膜下-腹腔分流术治疗。总之，婴儿头部损伤后，慢性SDH从急性SDH演变而来相对常见。头部受伤的婴儿，尤其是那些伴有急性SDH和早期硬膜下积液形成的婴儿，应仔细随访，特别关注慢性SDH的可能发展。
