Epidural Hematoma and Cerebral Palsy

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An epidural hematoma is a form of traumatic brain injury marked by bleeding that occurs inside the skull, the dura (outer covering of the brain), and sometimes in the spinal column. An epidural hematoma in an infant may lead to the development of cerebral palsy. It is considered a severe and life-threatening injury that requires immediate medical treatment.

About Epidural Hematoma

An epidural hematoma occurs when a blood vessel (usually an artery) ruptures. This can happen when a skull fracture develops during a childhood accident.

It can also occur shortly before, during, or after childbirth if an infant experiences a stroke. Babies are prone to having strokes if their mothers have an infection or preeclampsia.[1]

Medical mistakes can also lead to babies developing an epidural hematoma. It’s not the most common cause of the injury. Still, it can happen when doctors fail to use birth assisting tools properly or fail to pull an infant out correctly during childbirth (generally, the baby is in the breech position when this happens).

There are even cases of a hematoma developing because the baby was dropped shortly after being delivered.[2]

The Connection Between Cerebral Palsy and Epidural Hematoma

Infants who develop epidural hematoma are at risk for a lack of oxygen to the brain. This is linked to a risk of brain damage, which in turn is linked to cerebral palsy.

Cerebral palsy is typically diagnosed between the ages of 1 and 2 years. Some children with cerebral palsy are not diagnosed until 3-5 years of age.

If your baby experiences an epidural hematoma, keep an eye out for possible cerebral palsy symptoms. Your child’s pediatrician will also closely monitor your child’s growth and development.

Some symptoms are more apparent than others, such as spastic movements, but other signs and symptoms to look out for include:

• Developmental delays
• Speech difficulties
• Difficulties grasping small objects
• Excessive drooling
• Varied muscle tone that can change from stiff to floppy
• Walking difficulties
• Hand curling inward towards the body

Keep in mind that these symptoms don’t automatically mean that your child has cerebral palsy. Talk to your pediatrician about these symptoms. Only a physician can make an accurate diagnosis of cerebral palsy.

Epidural Hematoma Treatment and Symptoms

Before treatment begins, a physician will perform a neurological exam to see if there’s an increase in intracranial pressure.

Increased intracranial pressure indicates an emergency situation. Treatment must start immediately, including emergency surgery, to reduce the pressure and the risk of developing more brain injuries.

Other forms of treatment include medications to help control symptoms and side effects. Seizure medications may be needed, as seizures commonly occur. Additional symptoms include:

• Drowsiness and lethargy
• Enlarged pupils
• Nausea with or without vomiting
• Head pain (which is hard to determine in infants)
• Fussiness and irritability
• Feeding problems
• Scalp swelling

Epidural Hematoma Prognosis

Epidural hematoma is a life-threatening condition, and if not treated promptly, it can be fatal.

The Centers for Disease Control and Prevention (CDC) states that 29% of infant deaths occur due to head trauma, but this will depend on how severe the trauma is. Other long-term issues may include seizures, cortical blindness, and migraines.

If your child suffered from an epidural hematoma, keep an eye on their symptoms. Talk to your pediatrician about any concerns and get treatment immediately.