Subdural hemorrhage

Case contributed by Dr Jeremy Jones

Presentation

Admitted generally unwell. Treated with antibiotics for a urinary infection. Bruising appeared during hospital stay. No explanation.

Patient Data

Age: 1 month
Gender: Male
CT

Increased high density in the region of the tentorium anteriorly. This is subdural blood and when you see it on the axials, you can confirm on the coronals.

No other hemorrhage. No fracture (MPR bony images not uploaded).

MRI

Extensive SWI drop-out consistent with hemorrhage overlying the tentorium. Additional right occipital focus of SWI signal drop-out appears to be hemorrhage within a sulcus.

Case Discussion

No history of head trauma and no neurological symptoms or evidence of encephalopathy. This case highlights the importance of recognizing that subdural hemorrhage may exist in the absence of neurological signs and symptoms.

If there is a child-protection concern raised by medical professionals with an appropriate background in child-protection, it is important to image appropriately despite a relative lack of objective neurological features.

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Case information

rID: 56435
Published: 1st Nov 2017
Last edited: 14th Aug 2019
System: Paediatrics
Inclusion in quiz mode: Included

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