The fluid is allowed to drain on its own accord, you should not aspirate. Usually the subdural collection is bilateral and often aspiration of one side removes most of the fluid. Tapping of the other side usually yields only small amount. Ultrasound examination or CT scanning monitors the collection. If after several attempts of subdural tap, the fluid is not cleared, subdural peritoneal shunt is considered.
Physical abuse is the leading cause of serious head injury in infants.
The classic syndrome consists of an infant mean age about 6 months with absent to minimal signs of external trauma, retinal haemorrhages and subdural haematomas. Shaken baby syndrome is difficult to diagnose because the child usually has little or no external evidence of trauma and the parents do not voluntary give a history of abuse. A history of shaking is not always obtained. Usually the child is grasped around the chest between two hands and repeatedly shaken with the head moving forward and backward causing rotational acceleration and deceleration injury. The chief complaints are usually vague and are similar to those seen in many infectious processes.