Infantile Acute Subdural Hematoma with Retinal Hemorrhage Caused by Minor Occipital Impact Witnessed by an ICU Nurse: A Case Report

Abstract

An acute subdural hematoma (ASDH) in infants without external signs of trauma is differently recognized as shaken baby syndrome (SBS) or abusive head trauma (AHT) in the United States or as infantile acute subdural hematoma (i-ASDH) due to minor head trauma in Japan. The aim of the present case report is to document the existence of i-ASDH as a discrete clinical entity differing from SBS and AHT. A 7-month-old male suffered a subdural hematoma and retinal hemorrhage after falling backwards from a sitting position while at home. Although the patient regained full activity in the emergency room, he was hospitalized for further observation. Six days after admission, the patient was witnessed by an ICU nurse falling backwards from a seated position on his bed and striking his occipital region against the bed railing. He began to cry and soon afterwards exhibited conjugate eye deviation, cyanosis, rigidity of the extremities, and loss of consciousness. An emergency CT revealed mixed-density ASDH, and an ophthalmologic examination disclosed multiple multilayered retinal hemorrhages. This case report