Following that the skull defect is repaired by cranioplasty, using autologous bone or metal if the skull defect is too large to be covered with bone. This is a curious condition that occurs in infants and usually the result of trauma. In infantile subdural haematoma there is a collection of subdural fluid, which vary from straw colour fluid to dark fluid haematoma. As I mentioned the condition is peculiar and its aetiology is obscure. The child presents with signs of raised intracranial pressure and tense fontanelle, enlarged head, irritability, vomiting and sunset eye signs.
Seizures can also occur.
Acute solid subdural haematoma is uncommon in children. It is important that when you do the subdural tap that you use a short bevel needle and you enter at an oblique angle to create a trap door effect. 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.