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. 2005 Sep;90(9):952–955. doi: 10.1136/adc.2003.037739

Subdural haematoma and effusion in infancy: an epidemiological study

C Hobbs 1, A Childs 1, J Wynne 1, J Livingston 1, A Seal 1
PMCID: PMC1720567  PMID: 16113132

Abstract

Aim: To determine incidence, aetiology, and clinical features of subdural haematoma and effusion (SDH/E) in infancy throughout the British Isles.

Methods: Cases were notified to the British Paediatric Surveillance Unit over 12 months by paediatricians, neurosurgeons, and paediatric and forensic pathologists.

Results: A total of 186 infants (121 boys, 65 girls) aged 0–2 years were identified. Annual incidence of SDH/E for the UK and Republic of Ireland is 12.54/100 000 aged 0–2 (95% CI 10.3 to 14.62) and 24.1/100 000 aged 0–1 (95% CI 20.89 to 28.18). A total of 106 infants suffered non-accidental head injury (NAHI), 7 accidental head injury, 26 a perinatal cause, 7 a non-traumatic medical condition, 23 meningitis, and in 17 the cause was undetermined; 35 infants died. Significant differences were found in injury pattern, body weight, and Townsend score between NAHI and SDH/E from other cause. There were fewer diagnostic investigations in non-NAHI cases. Delay in diagnosis of greater than a week occurred in 48/181.

Conclusion: SDH/E is a significant cause of morbidity and mortality in infancy. NAHI is the predominant cause of SDH/E. SDH/E can present in a non-specific and varied way and must be considered in any infant who is unwell. Determining the cause of the SDH/E in some cases continues to present a diagnostic challenge.

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Figure 1.

Figure 1

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 Postcode derived Townsend scores for abuse versus non-abuse quintiles (5 = least affluent, 1 = most affluent).

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