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 CASE REPORT
Year : 2013  |  Volume : 8  |  Issue : 3  |  Page : 235-238

"Rabbit Ear" scalp deformity caused by massive subdural effusion in infant following bilateral burr-hole drainage


Department of Neurosurgery, All India Institute of Medical Sciences and Associated Jai Prakash Narayan Apex Trauma Centre, New Delhi, India

Correspondence Address:
Guru Dutta Satyarthee
Department of Neurosurgery, All India Institute of Medical Sciences and Associated Jai Prakash Narayan Apex Trauma Centre, New Delhi - 110 029
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/1817-1745.123690

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Subdural effusion (SDE) in an infant is a rare clinical scenario, which may be secondary to a variety of etiologies. Massive SDE is an extremely rare complication of head injury. It usually runs a self-limiting course. Though neurosurgical intervention is occasionally needed, different methods of surgical procedure for management includes burr-hole alone, burr-holes with subdural drain placement, twist drill craniotomy with drain and even craniotomy. The authors report a rare case of progressive massive SDE, which despite bilateral burr-hole placement and drainage failed and presented with visual deterioration and massive bulge of scalp at burr-hole sites producing rabbit ear sign in a 10 month old infant. Ultimately cystoperitoneal shunt was carried out in a desperate attempt to prevent impending rupture of scalp sutures at sites of previous burr-hole placement. Astonishingly not only complete resolution of hygroma, but visual recovery also took place. Patient is doing well at 6 months following shunt with regaining normal vision and appropriate developmental milestones. A magnetic resonance imaging scan of brain at last follow-up revealed mild ventriculomegaly with subduro-peritoneal shunt in situ and rest of brain was unremarkable. Such cases have not been reported in literature until date.






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