Diagnosis and treatment of traumatic subdural hematomas in young children

Magnetic resonance imaging (MRI) of the brain and neurosonography are informative methods for detecting subdural hematomas and important for determining treatment tactics. In young children with subdural hematomas, the most acceptable method of neurosurgical treatment is percutaneous subdural puncture. Material and methods. During investigation in admission compression of the brain by subdural hematoma was found in 7 children. Among them, 3 children had a history of perinatal CNS lesions. And four victims were injured when they fell from a low height – from a stroller and a bed, in 3 cases the cause of the injury was a traffic accident. Results. MRI of the brain revealed sickle-shaped zones of altered density (increased in the zone of the acute phase of the process, reduced in the chronic course) located between the bones of the skull and the brain substance. There was marked swelling of the brain. The displacement of the average structures was in all cases. Along with traumatic changes in children with perinatal CNS damage, atrophic changes in the frontal lobes in 3 children and an increase in the size of the ventricular system in 4 children were revealed. Conclusion. In young children with subdural hematomas, in addition to bone-plastic trepanation of the skull, effective methods of surgical treatment are the imposition of milling holes with the establishment of supply and exhaust drains, through which subsequent sanitation of the subdural space and percutaneous puncture of the subdural hematoma is carried out under the control of neurosonography followed by drainage of the subdural space