Idiopathic peri-cerebral enlargement in infants: simple anatomical variant or hemorrhagic risk factor?

Archives de pédiatrie : organe officiel de la Sociéte française de pédiatrie
A GoutP Foucaud

Abstract

Idiopathic subarachnoid space enlargement (ISSE) is usually regarded as a benign lesion. Two infants, 6 and 8 months old respectively, were hospitalized for neurological disorders revealing subdural hematoma. The first one was drowsy after an apparent life threatening event. The CT scan showed a recent subdural hematoma with ISSE. The outcome was spontaneously uneventful. The second patient presented a febrile hemiconvulsion preceding a status epilepticus. The diagnosis of empyema complicating subdural hematoma with ISSE was done on MRI. Recovery occurred after a 3 week course of parenteral antibiotics and 1 year of antiepileptic treatment. In these two cases, there was no history of head injury and the retrospective study of cranial perimeter growth curves showed acceleration before the acute event. The reputation of benignity is not usurped regarding the ISSE. Nevertheless, it must be recognized as a factor furthering emergence of subdural hematoma, even in absence of injury context.

Citations

Mar 5, 2016·Journal of Neurosurgery. Pediatrics·Jacqueline TuckerJoseph Piatt
Jun 8, 2011·Neurosurgical Review·Sverre Morten ZahlKnut Wester
Mar 3, 2010·Child's Nervous System : ChNS : Official Journal of the International Society for Pediatric Neurosurgery·Matthieu VinchonNathalie Noulé
Mar 13, 2021·Acta neurochirurgica·Joseph Scheller, Knut Wester

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