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Child's Nervous System

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01-04-2008 | Original Paper

Management of acute subdural hematomas in infants: intrathecal infusion streptokinase for clot lysis combined with subdural to subgaleal shunt

Authors: Sergey N. Larionov, Vladimir A. Sorokovikov, Vladimir A. Novozilov

Published in: Child's Nervous System | Issue 4/2008

Abstract

Object

Subdural hematomas (SDHs) in full-term infants have the potential to cause death or lifelong disability. We report management and outcomes of eight cases of newborn with large SDH treated by streptokinase (SK) lavage and drainage.

Materials and methods

Between 2003 and 2006, eight infants with large acute SDH with focal or diffuse hypodensity showing signs and symptoms of neurological deterioration were treated by drainage and subdural SK lavage. There were eight full-term infants, five boys and three girls, with ages between 10 days and 2 months. Head injuries were shaken baby syndrome in three cases, fall from height in three cases, caused by traffic accident in one case, and reportedly not due to trauma in one case. In all patients, SDHs were unilateral. We used a new surgical approach, SDH evacuation, involving the subdural instillation of SK for lysis and after drainage of acute SDH in infants. Follow-up in the series ranged from 1 to 42 months (average 30 months). There was no mortality in this series, neither in the early postoperative period nor in the follow-up period. Five patients of this series lead a normal life; two children were mildly neurodevelopmentally delayed.

Conclusion

Subdural infusion of SK followed by drainage may be as safe and effective for treatment of acute SDHs in infants as other reported methods.

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Title: Management of acute subdural hematomas in infants: intrathecal infusion streptokinase for clot lysis combined with subdural to subgaleal shunt
Authors: Sergey N. Larionov
Vladimir A. Sorokovikov
Vladimir A. Novozilov
Publication date: 01-04-2008
Publisher: Springer-Verlag
Published in: Child's Nervous System / Issue 4/2008
Print ISSN: 0256-7040
Electronic ISSN: 1433-0350
DOI: https://doi.org/10.1007/s00381-007-0496-1

At a glance: The STEP trials

Springer Medicine

Management of acute subdural hematomas in infants: intrathecal infusion streptokinase for clot lysis combined with subdural to subgaleal shunt

Abstract

Object

Materials and methods

Conclusion

At a glance: The STEP trials

Springer Medicine

Abstract

Object

Materials and methods

Conclusion

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