Korean J Perinatol.  2016 Jun;27(2):103-109. 10.14734/kjp.2016.27.2.103.

Clinical Significance of Epidural Hematoma Related to Birth in Newborn

• Lee DJ
• Lee YK
• Ko SY
• Shin SM
• Han BH

• KMID: 2316287
• DOI: http://doi.org/10.14734/kjp.2016.27.2.103

Abstract

PURPOSE
Epidural hematoma (EDH) in newborn is very rare, but when it occurs it is usually due to birth injury. We have evaluated the incidence and clinical features of EDH related to birth in newborn.
METHODS
We analyzed medical records of 12 newborns diagnosed with EDH at Cheil General Hospital and Women's Health Care Center from January 2000 to December 2015 retrospectively.
RESULTS
The incidence of EDH related to birth was 0.01%, occurring in 1 of 10,000 live births. Of the total 12 cases, 10 occurred in male and 8 in vaginal delivery. Among them, 11 infants had evidences of birth injury. Clinical presentation was nonspecific: only 1 infant had neurologic symptoms. The temporooccipital area was the most frequent location of EDH. The median size of EDH was 3.2±0.8 cm in length and 1.2±0.7 cm in depth. Mass effect accompanied with midline shift on radiologic imaging was shown in one case. Surgical drainage was needed only in one infant with neurologic symptom and mass effect on radiologic imaging, while the others were treated conservatively.
CONCLUSION
Neonatal EDH related to birth was treated conservatively in most cases. The radiologic mass effect and neurologic symptom should be considered as indication for surgical intervention.

Keyword

Epidural hematoma; Newborn

MeSH Terms

Birth Injuries
Drainage
Hematoma*
Hospitals, General
Humans
Incidence
Infant
Infant, Newborn*
Live Birth
Male
Medical Records
Neurologic Manifestations
Parturition*
Retrospective Studies
Women's Health

Figure

• 

  Fig. 1 CT scans of case 10. Before (A) and after (B) surgical treatment. The EDH(arrow), shown as a lentiform high-density area on the left temporal region with mass effect(arrowhead), disappeared after surgery.

• 

  Fig. 2 CT scans of case 12. (A) Right parietal EDH (white arrow) without mass effect was shown on day 3. (B) After 2 days, follow-up image was obtained and it showed spontaneously decreased amount of EDH (black arrow) on the same region.

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