Posterior fossa chronic subdural hematoma in the neonate.

Acute neonatal posterior fossa subdural hematoma has been documented 13 times since 1940. Typically it occurs in a full-term infant whose delivery is complicated by forceps extraction or breech delivery. Lethargy, irritability, and respiratory irregularities occur within the first few days of life. Tense anterior fontanels and increasing head circumference result from progressive hydrocephalus. Multiple cranial nerve abnormalities may occur. Laboratory analysis reveals a diminishing hematocrit and bloody CSF. Prior to the CT era, diagnosis was made by clinical assessment, lumbar puncture, and angiography [1] . CT scanning has aided diagnosis in five of the 13 most recently reported cases. The authors in all five cases describe findings of abnormal high density in the posterior fossa. In 1980, Margolith et al. [2] emphasized the role of CT scanning in facilitating rapid diagnosis and treatment of posterior fossa subdural hematomas in the newborn. We report the first case of a chronic neonatal posterior fossa subdural hematoma.