Chronic Subdural Hygromas, Cerebral Atrophy, and Developmental Delay Following Paediatric Traumatic Brain Injury: A Case Report

Traumatic Brain Injury (TBI) contributes significantly to the burden on healthcare systems. The variability in patient profiles and injury mechanisms complicates prevention, diagnosis and treatment, limiting advancements in the field. Although imaging modalities like Computed Tomography (CT) and Magnetic Resonance Imaging (MRI) are essential in the diagnosis of TBI, they may miss subtle lesions. Children with TBI are at a high-risk of long-term neurological sequelae and these include seizures and developmental delays. This case report presents a six-year-old male child, fifth of birth order born out of non-consanguineous marriage, with developmental delays following history of fall at 2-3 months of age. Initial imaging studies reported bilateral Subarachnoid Haemorrhage (SAH) and inter-hemispheric bleeding. Subsequent scans revealed right-sided subdural hygroma and ischaemic infarcts. MRI brain findings demonstrated gliosis and cystic encephalomalacia. The patient developed Generalised Tonic-Clonic Seizures (GTCS), which were controlled with anticonvulsants. Later anticonvulsants were discontinued after a seizure-free period of two years. Upon recent admission, severe anaemia required blood transfusion and repeat MRI brain showed chronic subdural hygromas and cerebral atrophy. The patient was stabilised and discharged with ongoing developmental and neurological followup. This case underscores the significant long-term neurological and developmental consequences of paediatric TBI, highlighting the importance of early diagnosis, regular monitoring, and multidisciplinary management. Non-surgical approaches, combined with appropriate neuroimaging and clinical assessments, can effectively manage complications such as subdural hygromas and anaemia. Further research is needed to optimise care and improve outcomes for children affected by TBI.