Subdural hematoma in newborn baby is
associated with history of maternal trauma, complicated vaginal delivery,
instrumental delivery, foetal / maternal thrombocytopenia, coagulopathy,
hepatic disease, infection or using drugs during the pregnancy; but in the
absence of the above, intrauterine subdural hematoma is a rare event.
We present a newborn delivered to a healthy
mother at 38 weeks by elective caesarean section after he had been diagnosed
with macrocephaly by routine obstetric growth scan ultrasound at 35 weeks of
gestational age. The baby’s APGAR score was 4 at 1 minute, he was pale, his
fontanel was tense and his Occipitofrontal circumference (OFC) was 46 cm,
therefore, he was intubated immediately and transferred to Neonatal Intensive
Care Unit (NICU). Brain Computed tomography (CT –scan) revealed huge right
sided subacute subdural hematoma that was almost occupying the entire right
hemicranial space and severely compressing the underlying brain tissue. In
addition, there was marked dilatation of the left lateral ventricle with blood
clots at the occipital horn.
Subdural hematoma was evacuated by two burr
holes surgery, followed by repeated subdural tap. Intraventricular haemorrhage
treated by repeated ventricular tap until Cerebrospinal Fluid (CSF) became
clear, then ventriculoperitoneal shunt surgery was done for him.
Subdural hematoma, Newborn, Hydrocephalus, Burr
hole, Shunt surgery.