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    Go to the top of the page   ID: 20061112110821 Original case in german  More links about this topic on Pubmed (PubMed Reader)
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    Posterior fossa subdural hematoma and Cephalhematoma
    Samuel Stafrace, J Miller, H Shannon. Posterior fossa subdural hematoma and Cephalhematoma. PedRad [serial online] vol 6, no. 11.
    URL: www.PedRad.info/?search=20061112110821


     
     Pediatric Radiology CasesImages to this case: There are CT-images available for this case. [ CT ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   
     Pediatric Radiology CasesAuthor/s:

    Samuel Stafrace (Raigmore Hospital/Inverness/Scotland), J. Miller (Raigmore Hospital/Inverness/Scotland), H. Shannon (Raigmore Hospital/Inverness/Scotland)  

     
     Pediatric Radiology CasesEmail Address:

    Viewable for logged on visitors (Log on)  

     
     Pediatric Radiology CasesAge:

    2 Weeks  

     
     Pediatric Radiology CasesGender:

    Female  

     
     Pediatric Radiology CasesRegion-Organ:

    Head-Brain and brain nerves  

     
     Pediatric Radiology CasesMost likely etiology:

    physical  

     
     Pediatric Radiology CasesHistory: *

    Normal term baby.
    Difficult ventouse delivery.
    Low Apgar scores.  

     
     Pediatric Radiology CasesPathomorphology or Pathophysiology of this disease : *

    Subdural haematoma- collection of blood in potential space between pia-arachnoid and dura.Crosses suture lines. Limited by dural reflections. It is argued in the literatiure that neonatal subdural is not always indicative of birth trauma.

    Cephalhaematoma - Incidence: 2.5%. Increased incidence with vacuum extraction - up to 23%. Represents a subperiosteal collection of blood. Rarely complicated by infection in relation with aspiration, scalp electrode or general sepsis.  

     
     Pediatric Radiology CasesRadiological findings: *


    CT 1 <- view CT 1

    CT 1: demonstrates a crescentic extracranial hyperattenuated collection to the right of the skull vault which does not cross sutures.






    CT 2 <- view CT 2

    CT 2: demonstrates a crescentic hyperattenuated collection in the posterior fossa.






    CT 3 <- view CT 3

    CT 3: shows extention of the infratentorial collection above the tentorium adjacent to the posterior falx.






    MRI 1 <- view MRI 1

    MRI 1: - Sagittal T1 image showing a crescentic high signal collection in the posterior fossa and mixed signal in the extracranial collection.






    MRI 2 <- view MRI 2

    MRI 2: - Axial T1 (GRE) image showing a crescentic high signal collection in the posterior fossa.





     

     
     Pediatric Radiology CasesDiagnosis confirmation:

    Expert's opinion  

     
     Pediatric Radiology CasesWhich DD would be also possible with the radiological findings: *

    Extracranial collection - Caput succedaneum; oedema not blood and crosses suture lines.

    Posterior fossa collection-
    Extradural which would have an elliptical configuration and does not cross sutures.
    Subarachnoid blood - would be seen between the sulci. Both unlikely in this case.
     

     
     Pediatric Radiology CasesCourse / Prognosis / Frequency / Other : *

    Subdural haematoma - Majority treated with expectant therapy. Depends on size and clinical condition.

    Cephalhaematoma - Conservative treatment. Surgical if ossified and causing skull deformities.  

     
     Pediatric Radiology CasesComments of the author about the case: *

    Good example of two different pathologies related to birth.

    Shows different signal in both haematomas on MRI.  

     
     Pediatric Radiology CasesFirst description / History: *

    N/A  

     
     Pediatric Radiology CasesLiterature:

    1. Medline: Medline
    Dahnert Wolfgang
    Radiology Review Manual 5th edition
    Lippincott Williams and Wilkins.

    2. Medline: Medline
    Chamnanvanakij S, Rollins N, Perlman JM
    Subdural hematoma in term infants.
    Pediatr Neurol. 2002 Apr;26(4):301-4

    3. Medline: Medline
    Chen MH, Yang JC, Huang JS, Chen MH
    MRI features of an infected cephalhaematoma in a neonate.
    J Clin Neurosci. 2006 Oct;13(8):849-52. Epub 2006 Aug 22

    4. Medline: Medline
    Johanson RB, Menon BK
    Vacuum extraction versus forceps for assisted vaginal delivery.
    Cochrane Database Syst Rev. 2000;(2):CD000224

    5. Medline: Medline
    Thacker KE, Lim T, Drew JH
    Cephalhaematoma: a 10-year review
    Aust N Z J Obstet Gynaecol. 1987 Aug;27(3):
    210-2

    6. Medline: Medline
    Chung HY, Chung JY, Lee DG, Yang JD, Baik BS, Hwang SG, Cho BC.
    Surgical treatment of ossified cephalhematoma.
    J Craniofac Surg. 2004 Sep;15(5):774-9  

     
     Pediatric Radiology CasesKeywords: *

    birth related subdural hematoma, posterior fossa bleed, cephalhaematoma, cephalhematoma, extracranial bleed, child, childhood, pediatric radiology  

     
     Pediatric Radiology Cases Cite this article:

    Samuel Stafrace, J Miller, H Shannon. Posterior fossa subdural hematoma and Cephalhematoma. PedRad [serial online] vol 6, no. 11.
    URL: www.PedRad.info/?search=20061112110821  

     
     Pediatric Radiology Cases Read similar articles: with corresponding keywords
    in the same field: Head-Brain and brain nerves
    or in the region: Head
    or in the tissue/organ: Brain and brain nerves
    or with the etiology: physical
     
     Pediatric Radiology CasesImages to this case: There are CT-images available for this case. [ CT ] There are MRI-images available for this case. [ MRI ] View all modalities [ All ]   

    Thanks to Martina Paetzel, M.D. for translating this case!

     
    Posterior fossa subdural hematoma and Cephalhematoma
    Samuel Stafrace, J Miller, H Shannon. Posterior fossa subdural hematoma and Cephalhematoma. PedRad [serial online] vol 6, no. 11.
    URL: www.PedRad.info/?search=20061112110821


     

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    Posterior fossa subdural hematoma and Cephalhematoma
    Other cases by these authors:

    Search Samuel Stafrace in Medline Samuel Stafrace (3)   
    Search J. Miller in Medline J. Miller (1)   
    Search H. Shannon in Medline H. Shannon (2)   

    Posterior fossa subdural hematoma and Cephalhematoma  
     
    Posterior fossa subdural hematoma and Cephalhematoma
    Samuel Stafrace, J Miller, H Shannon. Posterior fossa subdural hematoma and Cephalhematoma. PedRad [serial online] vol 6, no. 11.
    URL: www.PedRad.info/?search=20061112110821


     

    Which diagnosis have other collegues guessed?


    • Caput succedaneum and subdural hematoma
      Votes: 5 (27 %)


    • Extradural hematoma and subarachnoid hemorrhage
      Votes: 2 (11 %)


    • Subdural hematoma and cephalhematoma
      Votes: 8 (44 %)


    • Subarachnoid hemorrhage and caput succedaneum
      Votes: 3 (16 %)



        Total answers: 18

     
    Posterior fossa subdural hematoma and Cephalhematoma
    Samuel Stafrace, J Miller, H Shannon. Posterior fossa subdural hematoma and Cephalhematoma. PedRad [serial online] vol 6, no. 11.
    URL: www.PedRad.info/?search=20061112110821


     

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    Posterior fossa subdural hematoma and Cephalhematoma
    Samuel Stafrace, J Miller, H Shannon. Posterior fossa subdural hematoma and Cephalhematoma. PedRad [serial online] vol 6, no. 11.
    URL: www.PedRad.info/?search=20061112110821


     




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