UROSURGICAL MANAGEMENT OF CHRONIC SUBDURAL HEMATOMAS IN CHILDREN

Chronic subdural hematoma (cSDH) is a relatively rare but important neurosurgical condition in the pediatric population, most often caused by head trauma, cerebrospinal fluid shunting, blood coagulation disorders, or spontaneous bleeding into the subdural space. Although cSDH is much more common in adults, children may develop chronic collections of blood between the dura mater and arachnoid membrane due to a combination of anatomical vulnerability and pathological predispositions. Pediatric cSDH may present with subtlesymptoms such as headache, irritability, vomiting, changes in behavior, or neurologic deficits, and diagnosis often relies on neuroimaging including computed tomography and magnetic resonance imaging. The natural history and optimal management strategies in children are less well defined than in adults, but neurosurgical intervention — most commonly burr hole evacuation with subdural drainage — is indicated for symptomatic or large collections. Recent literature has also explored adjunctive approaches such as middle meningeal artery embolization, though high-quality evidence in children remains limited. Early recognition, careful evaluation of underlying causes, and tailored surgical care are essential for good outcomes.