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Journal of Child Neurology
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Acute Epidural Hematoma With Infarction of the Right Hemisphere in a 5-Month-Old Child: Case Report With a Long-Term Follow-Up and a Review of the Literature

Peter T. Ulrich, MD, PhD

Department of Neurosurgery, Klinikum Offenbach GmbH, Offenbach, Germany, peter.ulrich{at}klinikum-offenbach.de

Helmut Fuessler, MD

Department of Neurosurgery, Klinikum Offenbach GmbH, Offenbach, Germany

Elke Januschek, MD

Department of Neurosurgery, Klinikum Offenbach GmbH, Offenbach, Germany

Two hours after a fall, a 5-month-old girl was admitted to our hospital because of an extended galea hematoma and restlessness. Five hours after the trauma, a left hemiparesis developed. The child became drowsy. The hematocrit had fallen to 7.1 g/dL. Cranial computerized tomography disclosed a huge frontoparietal epidural hematoma on the right side and a hypodensity in the territories of the middle and posterior cerebral arteries. Immediately before surgery, the right pupil dilated. After evacuation of the epidural hematoma and ligation of the middle meningeal artery, the girl recovered satisfactorily. Nevertheless, magnetic resonance imaging showed a vast defect zone in the territories of the right middle and posterior cerebral arteries. Six weeks after the injury, the visual-evoked potentials were unavailable on both sides. Four years after the accident, visual assessment revealed normal acuity and stereopsis. Cognitive and neuromotor development were undisturbed and appropriate to the age.

Key Words: epidural hematoma • cerebral infarction • head injury

Journal of Child Neurology, Vol. 23, No. 9, 1066-1069 (2008)
DOI: 10.1177/0883073808315411
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