Epidural hematoma treated by aspiration of accompanying cephalhematoma in a newborn infant

신생아에서 동반된 두혈종 흡인으로 치료된 경막외출혈 1례

  • Oh, Ki Won (Department of Pediatrics, College of Medicine, Ulsan University Hospital) ;
  • Kim, Heng Mi (Department of Pediatrics, College of Medicine, Kyungpook National University)
  • 오기원 (울산대학교 의과대학 소아과학교실) ;
  • 김행미 (경북대학교 의과대학 소아과학교실)
  • Received : 2007.08.19
  • Accepted : 2007.09.10
  • Published : 2007.11.15

Abstract

Epidural hematoma is relatively rare in newborn infants and frequently associated with instrumental deliveries or other complications during labor and delivery. Although surgical evacuation has been the most common therapy, many other procedures have been described. Although many epidural hematomas require surgical evacuation rather than nonsurgical management, conservative or aspiration of hematoma have been attempted. In the case of EDH associated with cephalhematoma, aspiration of cephalhematoma could be attempted because frequent features of these combination were communication between these hematoma. We report a case of successful nonsurgical management of epidural hematoma through the aspiration of accompanying cephalhematoma in a 5-day-old newborn infant.

신생아기에 발생하는 경막외출혈은 매우 드문 분만손상 중 하나로 주로 기구분만이나 분만과 관련된 합병증과 연관이 많은 편이다. 치료로는 수술적 배혈이 주로 시도되고 있으나 수술적 치료 이외의 고식적 치료, 경막외 혈종의 흡인, 동반된 두혈종을 통한 흡인 등 다양한 비수술적 방법들이 시도되고 있다. 저자들은 두혈종이 동반된 경막외출혈을 보였던 5일된 신생아에 대해 동반된 두혈종 흡인을 통해 경막외출혈을 비수술적으로 치료하였기에 문헌고찰과 함께 보고하는 바이다.

Keywords

References

  1. Noetzel MJ. Perinatal trauma and cerebral palsy. Clin Perinatol 2006;33:355-66 https://doi.org/10.1016/j.clp.2006.03.003
  2. Uhing MR. Management of birth injuries. Clin Perinatol 2005;32:19-38 https://doi.org/10.1016/j.clp.2004.11.007
  3. Heyman R, Heckly A, Magagi J, Pladys P, Hamlat A. Intracranial epidural hematoma in newborn infants: clinical study of 15 cases. Neurosurgery 2005;57:924-9 https://doi.org/10.1227/01.NEU.0000180026.73246.bf
  4. Yamamoto T, Enomoto T, Nose T. Epidural hematoma associated with cephalohematoma in a neonate-case report. Neurol Med Chir (Tokyo) 1995;35:749-52 https://doi.org/10.2176/nmc.35.749
  5. Negishi H, Lee Y, Itoh K, Suzuki J. Nishino M, Takada S, et al. Nonsurgical management of epidural hematoma m neonates. Pediatr Neurol 1989;5:253-6 https://doi.org/10.1016/0887-8994(89)90086-6
  6. Akiyama Y, Moritake K, Maruyama N, Takamura M, Yamasaki T. Acute epidural hematoma related to cesarean section in a neonate with Chiari II malformation. Childs Nerv Syst 2001;17:290-3 https://doi.org/10.1007/s003810000408
  7. Gama CH, Fenichel GM. Epidural hematoma of the newborn due to birth trauma. Pediatr Neurol 1985;1:52-3 https://doi.org/10.1016/0887-8994(85)90010-4
  8. Vinchon M, Pierrat V, Tchofo PJ, Soto-Ares G, Dhelle mmes P. Traumatic intracranial hemorrhage in newborns. Childs Nerv Syst 2005;21:1042-8 https://doi.org/10.1007/s00381-004-1131-z
  9. Vachharajani A, Mathur A. Ultrasound-guided needle aspiration of cranial epidural hematoma in a neonate: treating a rare complication of vacuum extraction. Am J Perinatol 2002;19:401-4 https://doi.org/10.1055/s-2002-36837
  10. Takagi T, Nagai R, Wakabayashi S, Mizawa I, Hayashi K. Extradural hemorrhage in the newborn as a result of birth trauma. Childs Brain 1978;4:306-18
  11. Hamlat A, Heckly A, Adn M, Poulain P. Pathophysiology of intracranial epidural haematoma following birth. Med Hypotheses 2006;66:371-4 https://doi.org/10.1016/j.mehy.2005.08.045
  12. Hymel KP. Traumatic intracranial injuries can be clinically silent. J Pediatr 2004;144:701-2 https://doi.org/10.1016/S0022-3476(04)00281-1
  13. Pozzati E, Tognetti F. Spontaneous healing of acute extradural hematomas: study of twenty-two cases. Neurosurgery 1986;18:696-700 https://doi.org/10.1227/00006123-198606000-00003
  14. Pang D, Horton JA, Herron JM, Wilberger JE, Jr., Vries JK. Nonsurgical management of extradural hematomas in children. J Neurosurg 1983;59:958-71 https://doi.org/10.3171/jns.1983.59.6.0958
  15. Beni-Adani L, Flores I, Spektor S, Umansky F, Constantini S. Epidural hematoma in infants: a different entity? J Trauma 1999;46:306-11 https://doi.org/10.1097/00005373-199902000-00018
  16. Dos Santos AL, Plese JP, Ciquini Junior O, Shu EB, Manreza LA, Marino Junior R. Extradural hematomas in children. Pediatr Neurosurg 1994;21:50-4
  17. Chen TY, Wong CW, Chang CN, Lui TN, Cheng WC, Tsai MD, et al. The expectant treatment of 'asymptomatic' supratentorial epidural hematomas. Neurosurgery 1993;32: 176-9 https://doi.org/10.1227/00006123-199302000-00004
  18. Knuckey NW, Gelbard S, Epstein MH. The management of 'asymptomatic' epidural hematomas. A prospective study. J Neurosurg 1989;70:392-6 https://doi.org/10.3171/jns.1989.70.3.0392
  19. Aoki N. Epidural hematoma communicating with cephalhematoma in a neonate. Neurosurgery 1983;13:55-7 https://doi.org/10.1227/00006123-198307000-00011