Bitonti Talia Mia, MacDonald Kaylea Noel, Datta Debajoyti, Tu Albert
Department of Critical Care, University of Ottawa, The Ottawa Hospital, Ottawa, ON, Canada.
Department of Neurosurgery, Children's Hospital of Eastern Ontario, University of Ottawa, Ottawa, ON, Canada.
Childs Nerv Syst. 2025 Nov 7;41(1):344. doi: 10.1007/s00381-025-07017-7.
Subdural hematomas (SDHs) in infants present diagnostic challenges due to their diverse aetiologies ranging from non-accidental injury to metabolic or coagulopathic disorders. Clinical presentation includes vomiting, irritability, and bulging fontanelles. There are multiple surgical and non-surgical options available for management aimed at relieving mass effect. We report the unusual development of acute ventriculomegaly and downward gaze palsy in a clinically well 9-week-old boy following evacuation of bilateral subacute subdural hematomas. Neuroimaging revealed ventricular enlargement without other overt clinical features of hydrocephalus, and the symptoms resolved without CSF diversion. We hypothesize that the ventriculomegaly and downward gaze deviation were caused by altered CSF pressure gradient due to communication between the subarachnoid, subdural, and subgaleal spaces.
婴儿硬膜下血肿（SDH）因其病因多样，从非意外性损伤到代谢或凝血障碍，给诊断带来挑战。临床表现包括呕吐、易激惹和囟门隆起。针对减轻占位效应，有多种手术和非手术治疗方案可供选择。我们报告了一名9周大临床状况良好的男婴，在双侧亚急性硬膜下血肿清除术后出现急性脑室扩大和向下凝视麻痹的不寻常情况。神经影像学显示脑室扩大，但无其他明显的脑积水临床特征，且症状在未进行脑脊液分流的情况下自行缓解。我们推测，脑室扩大和向下凝视偏差是由于蛛网膜下腔、硬膜下腔和帽状腱膜下腔之间的交通导致脑脊液压力梯度改变所致。
