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24.04.2020 | original article | Ausgabe 17-18/2020 Open Access

Wiener klinische Wochenschrift 17-18/2020

Management and outcome of traumatic subdural hematoma in 47 infants and children from a single center

Zeitschrift:
Wiener klinische Wochenschrift > Ausgabe 17-18/2020
Autoren:
M.D. Harald Binder, M.D. Thomas M. Tiefenboeck, PhD Marek Majdan, MBBS Micha Komjati, M.D. Rupert Schuster, M.D. Stefan Hajdu, M.D. Johannes Leitgeb
Wichtige Hinweise

Electronic supplementary material

The online version of this article (https://​doi.​org/​10.​1007/​s00508-020-01648-3) contains supplementary material, which is available to authorized users.

Availability of data and material

The datasets generated and/or analyzed during the current study are not publicly available due to data privacy but are available from the corresponding author on reasonable request.
Investigation performed at the Department of Trauma Surgery, Medical University of Vienna, Vienna General Hospital, Vienna, Austria

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Springer Nature remains neutral with regard to jurisdictional claims in published maps and institutional affiliations.

Summary

Background

Traumatic brain injury (TBI) is a frequent cause of mortality and acquired neurological impairment in children. It is hypothesized, that with the adequate treatment of SDH in children and adolescence, excellent clinical and functional outcomes can be achieved. The aim of this study was to present the severity and outcome of traumatic SDH in children and adolescence as well as to analyze differences between patients treated surgically and conservatively.

Methods

In this study 47 infants and children with a subdural hematoma (SDH) were treated between 1992 and 2010 at a single level-one trauma center. Data regarding accident, treatment and outcomes were collected retrospectively. To classify the outcomes the Glasgow outcome scale (GOS) scores at hospital discharge and at follow-up visits were used. Severity of SDH was classified according to the Rotterdam score.

Results

In total, 47 cases were treated (21 surgically, 26 conservatively), with 10 patients needing delayed surgery. Overall, 89% of the patients were able to leave hospital, 5 patients died, 2 patients (5%) within 24 h, another 2 (5%) after 48 h and 1 (2%) within 7 days. In 25 patients (53%) a good recovery was recorded at the last follow-up visit. Outcome was mainly influenced by the following factors: age, severity of TBI, and neurological status. Overall, in 70% good clinical and neurological outcomes could be achieved.

Conclusion

The results of this study confirmed that pediatric SDH is a rare, but serious condition. Despite a poor prognosis, most patients could be treated with good outcomes, given that the choice of treatment is correct.

Trial registration

Research registry 2686

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