An 8-year-old male presented with multiple trauma caused by a bicycle accident.
At the event, the patient has a full helmet and a protective helmet, presenting the impact head trauma with loss of knowledge and cervical hyperexpression.
Upon arrival to our center, the patient is in GCS 13 and presents paresis of the VI right cranial nerve.
Cranial and cervical CT showed a retroclival and spinal subdural hemorrhagic lesion.
No skull base or cervical fractures were observed.
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Abdominal CT scan ruled out other lesions with normal coagulation parameters.
The patient remains neurologically stable so it was decided to perform conservative management with placement of rigid collaring.
The study of the lesion was completed with a craniocervical resonance that ruled out lesions of ligament structures in the craniocervical junction.
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The patient presented clinical improvement with 15 points in the Glasgow scale at 24 hours and resolution of the LV paresis at 6 days.
After one week of evolution, a reduction in subdural hematoma was verified by cranial-cervical CT and atlo-axoid stability by cervical functional radiographs.
Three months later the patient presented complete resolution of the subdural hematoma with complete neurological recovery.
