Subdural haematoma and effusion in infancy: an epidemiological study. Issue 9 (19th August 2005)

• Record Type: Journal Article
• Authors: Hobbs, C; Childs, A-M; Wynne, J; Livingston, J; Seal, A
• Is Part Of: Archives of disease in childhood. Volume 90:Issue 9(2005)
• Page Start: 952
• Page End: 955
• Publication Date: 2005-08-19
• Subjects: NAHI, non-accidental head injury -- SDH/E, subdural haematoma and effusion; subdural haematoma -- subdural effusion -- infancy -- non-accidental head injury -- neurodevelopmental outcome; Children -- Diseases -- Periodicals; Infants -- Diseases -- Periodicals; 618.920005
• DOI: 10.1136/adc.2003.037739
• Languages: English
• ISSNs: 0003-9888

Abstract

Abstract : Aim: To determine incidence, aetiology, and clinical features of subdural haematoma and effusion (SDH/E) in infancy throughout the British Isles. Methods: Cases were notified to the British Paediatric Surveillance Unit over 12 months by paediatricians, neurosurgeons, and paediatric and forensic pathologists. Results: A total of 186 infants (121 boys, 65 girls) aged 0–2 years were identified. Annual incidence of SDH/E for the UK and Republic of Ireland is 12.54/100 000 aged 0–2 (95% CI 10.3 to 14.62) and 24.1/100 000 aged 0–1 (95% CI 20.89 to 28.18). A total of 106 infants suffered non-accidental head injury (NAHI), 7 accidental head injury, 26 a perinatal cause, 7 a non-traumatic medical condition, 23 meningitis, and in 17 the cause was undetermined; 35 infants died. Significant differences were found in injury pattern, body weight, and Townsend score between NAHI and SDH/E from other cause. There were fewer diagnostic investigations in non-NAHI cases. Delay in diagnosis of greater than a week occurred in 48/181. Conclusion: SDH/E is a significant cause of morbidity and mortality in infancy. NAHI is the predominant cause of SDH/E. SDH/E can present in a non-specific and varied way and must be considered in any infant who is unwell. Determining the cause of the SDH/E in some cases continues to present a diagnostic challenge.