Bergene Eyerusalem, Tira Abdi Ermolo, Hussen Endris, Smith Caitlyn J, Fetle Yonas T
Department of Neurosurgery, St. Paul's Millennium Medical College, Addis Ababa, Ethiopia.
Department of Neurosurgery, St. Peter's Comprehensive Specialized Hospital, Addis Ababa, Ethiopia.
Int Med Case Rep J. 2023 Jun 8;16:351-355. doi: 10.2147/IMCRJ.S413163. eCollection 2023.
Chronic supratentorial subdural hematoma is uncommon in neonates but accounts for most neurosurgical procedures in neonatal age. However, its occurrence in the posterior fossa is extremely rare. It can be caused by instrumental delivery, coagulation abnormality, hypoxic insult, and various structural abnormalities. Furthermore, spontaneous onset has been reported only in a few case reports.
A twenty-nine-day-old male neonate presented with failure to suck for three days duration associated with vomiting. Imaging showed bilateral posterior fossa chronic subdural hematoma and obstructive hydrocephalus. Bilateral burrhole craniostomy and hematoma evacuation was done which resulted in an excellent outcome.
Posterior fossa chronic subdural hematoma is extremely rare in the neonatal period. It can be caused by various possible etiologic agents; however, rarely it can occur spontaneously. Management with suboccipital burrhole craniostomy and hematoma evacuation can result in a good outcome. Intraoperative monitoring and management with an experienced anesthesiology team are indispensable for a good outcome.
Pediatrics neurosurgery ward, St Peter's Comprehensive Specialized Hospital, Addis Ababa, Ethiopia.
慢性幕上硬膜下血肿在新生儿中并不常见，但却占新生儿期大多数神经外科手术病例。然而，其在后颅窝的发生极为罕见。它可由器械助产、凝血异常、缺氧损伤及各种结构异常引起。此外，仅有少数病例报告曾报道过自发性起病。
一名29日龄男婴，出现持续3天的吸吮无力并伴有呕吐症状。影像学检查显示双侧后颅窝慢性硬膜下血肿及梗阻性脑积水。遂行双侧钻孔开颅术及血肿清除术，术后效果良好。
后颅窝慢性硬膜下血肿在新生儿期极为罕见。它可由多种可能的病因引起；然而，很少会自发发生。枕下钻孔开颅术及血肿清除术的治疗可取得良好效果。术中监测及由经验丰富的麻醉团队进行管理对于取得良好疗效不可或缺。
埃塞俄比亚亚的斯亚贝巴圣彼得综合专科医院儿科神经外科病房
