Infant with subdural hygroma and expanded subarachnoid space

Case contributed by Dr Joseph Scheller

Presentation

Fussy infant with a large head.

Patient Data

Age: 5 months
Gender: Female

Left and right extra axial fluid collections, left side is more dense than right. Left chronic subdural hygroma. Right chronic enlarged subarachnoid space.

Left chronic subdural hygroma (protein laden fluid is less hypointense than spinal fluid). Right chronic enlarged subarachnoid space (spinal fluid is hypointense on T1).

Case Discussion

On day 2 of hospitalisation, the infant underwent a left sided subdural tap. Several millilitres of bloody spinal fluid was removed.

Two common causes of infant macrocephaly are BESS (benign expansion of subarachnoid spaces) and subdural hygroma. Many believe that chronic subdural hygromas in infants are caused by leakage of cerebrospinal fluid from the subarachnoid space into the potential subdural space

The connection between the two conditions would explain why this child has both. This connection between BESS and chronic subdural hygromas in infants has been reported 1.

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Case information

rID: 53879
Case created: 11th Jun 2017
Last edited: 18th Aug 2017
Inclusion in quiz mode: Excluded

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