Subdural Hematoma in an Infant with Glutaric Aciduria Type 1: A Case Report on Conservative Management.

IF 1 4区 医学 Q3 MEDICINE, GENERAL & INTERNAL
Lúcia Marques, Patrícia Lipari Pinto, Hugo Loureiro Cadilha, Patrícia Janeiro, Ana Gaspar
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引用次数: 0

Abstract

Glutaric aciduria type 1 is an inherited metabolic disorder associated with subdural hematomas, possibly due to the widening of external cerebrospinal fluid spaces. We present the case of an infant with macrocephaly since birth, diagnosed with glutaric aciduria type 1 through newborn screening, who exhibited accelerated cephalic growth during follow-up. At eight months of age, cranial magnetic resonance imaging revealed bilateral subdural hematomas with intracranial mass effect. The infant displayed no signs of intracranial hypertension, history of trauma, or signs of abuse. Although surgical treatment was considered, a multidisciplinary discussion led to the decision to manage conservatively with close monitoring. The patient remained clinically stable, and imaging showed a clear reduction in the dimensions of the hematomas. This case highlights that conservative management can be an effective approach for large subdural hematomas with mass effect in glutaric aciduria type 1, provided there is no associated symptomatology, thereby avoiding the risk of metabolic decompensation.

1型戊二酸尿婴儿硬膜下血肿:保守治疗1例。
戊二酸尿1型是一种与硬膜下血肿相关的遗传性代谢疾病,可能是由于脑脊液外腔变宽所致。我们提出的情况下,一个婴儿与出生大头畸形,诊断为戊二酸尿1型通过新生儿筛查,谁表现出加速头生长在随访期间。8个月大时,颅磁共振成像显示双侧硬膜下血肿伴颅内肿块效应。婴儿没有颅内高压的迹象,没有外伤史,也没有受虐待的迹象。虽然考虑手术治疗,但多学科讨论导致决定保守管理并密切监测。患者保持临床稳定,影像学显示血肿尺寸明显缩小。本病例强调,在没有相关症状的情况下,保守治疗对于1型戊二酸尿伴团块效应的大硬膜下血肿是一种有效的方法,从而避免了代谢失代偿的风险。
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来源期刊
Acta medica portuguesa
Acta medica portuguesa MEDICINE, GENERAL & INTERNAL-
CiteScore
1.90
自引率
16.70%
发文量
256
审稿时长
6-12 weeks
期刊介绍: The aim of Acta Médica Portuguesa is to publish original research and review articles in biomedical areas of the highest standard, covering several domains of medical knowledge, with the purpose to help doctors improve medical care. In order to accomplish these aims, Acta Médica Portuguesa publishes original articles, review articles, case reports and editorials, among others, with a focus on clinical, scientific, social, political and economic factors affecting health. Acta Médica Portuguesa will be happy to consider manuscripts for publication from authors anywhere in the world.
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