Birth-Related Subdural Hemorrhage in Asymptomatic Newborns: Magnetic Resonance Imaging Prevalence and Evolution of Intracranial and Intraspinal Localization.

Background: Neonatal birth-related intracranial subdural hemorrhages (SDHs) represent a form of bleeding inside the skull that occurs in newborns. This condition includes the extravasation of blood both in the encephalic parenchyma and in the extra-axial spaces. Recent studies have shown that SDH and particularly post-traumatic birth-related hemorrhages represent a frequent occurrence, but they are often asymptomatic. The gold standard for the diagnosis and follow-up of patients with SDH is multiparametric Magnetic Resonance Imaging. The aim of this study is to describe our experience by reporting several cases of SDH with different distribution and Central Nervous System involvement by the MRI of this pathology in infants up to 30 days of age. Methods: We analyzed the age and sex of the patients included in this study, the localization of SDH in different CNS areas, and their frequency using distribution plots and pie charts. Results: About the analysis of the SDH locations in the 32 patients, the most common location was the cerebellum (31/32, 96.9%), followed by parietal and occipital lobes (19/32, 59.4%; 18/32, 56.2%, respectively), falx cerebri (11/32, 34.4%), tentorium cerebelli (10/32, 31.2%), temporal lobes (6/32, 18.7%), and finally cervical and dorsal spine in the same patients (4/32, 12.5%). According to SDH locations, the patients were divided into supratentorial, infratentorial, both, and Spinal Canal. Conclusions: Our study confirmed the literature data regarding the neonatal birth-related SDH high frequency, but also allowed us to focus our attention on the rarest spinal SDH localizations with the same benign evolution.