Neonatal Spontaneous Bilateral Posterior Fossa Chronic Subdural Hematoma and Obstructive Hydrocephalus with a Successful Outcome: A Case Report

Abstract

Background

Chronic supratentorial subdural hematoma is uncommon in neonates but accounts for most neurosurgical procedures in neonatal age. However, its occurrence in the posterior fossa is extremely rare. It can be caused by instrumental delivery, coagulation abnormality, hypoxic insult, and various structural abnormalities. Furthermore, spontaneous onset has been reported only in a few case reports.

Case Presentation

A twenty-nine-day-old male neonate presented with failure to suck for three days duration associated with vomiting. Imaging showed bilateral posterior fossa chronic subdural hematoma and obstructive hydrocephalus. Bilateral burrhole craniostomy and hematoma evacuation was done which resulted in an excellent outcome.

Conclusion

Posterior fossa chronic subdural hematoma is extremely rare in the neonatal period. It can be caused by various possible etiologic agents; however, rarely it can occur spontaneously. Management with suboccipital burrhole craniostomy and hematoma evacuation can result in a good outcome. Intraoperative monitoring and management with an experienced anesthesiology team are indispensable for a good outcome.

Study Setting

Pediatrics neurosurgery ward, St Peter’s Comprehensive Specialized Hospital, Addis Ababa, Ethiopia.

Keywords:

• posterior fossa
• chronic
• subdural hematoma
• neonate

Abbreviations

CBC, Complete blood count; CPR, Cardiopulmonary resuscitation; CSF, Cerebrospinal fluid; CT, Computerized tomography; ICU, Intensive care unit; MRI, Magnetic resonance imagining; PFSDH, Posterior fossa subdural hematoma; SDH, Subdural hematoma.

Patient Consent

Written consent for publication was obtained from the neonate’s mother. We have also received approval for publication from the hospital where the patient was managed.

Disclosure

The authors report no conflicts of interest in this case report.