Infantile traumatic subdural hematomas: outcome after five years.

OBJECTIVE

Although subdural hematomas (SDH) are common in infants, their long-term outcome is poorly documented in the literature.

METHODS

Infants operated for SDH were followed prospectively and evaluated during their sixth year with systematic neurological evaluation and standard neuropsychological testing.

RESULTS

We studied 48 infants operated for SDH. At the last checkup, 39 were normal, 5 had mild deficits, 3 had severe deficits and 1 was in a vegetative state. IQ measurements did not differ significantly from normal values, but did not accurately reflect the outcome. The only independent factor significantly affecting the final outcome was initial clinical severity. Age at surgery, surgical complications and the nature of the trauma (inflicted or accidental) did not independently influence the outcome.

CONCLUSION

Long-term follow-up is required after treatment of SDH, to evaluate the child's changing needs in terms of medical and educational care.