ABSTRACT
In an infant with cerebral haematoma, child abuse should be considered. Children may present with irritability, vomiting, bulging fontanelle and focal seizure. Compared to adults, children have higher brain water content, the size of the head is relatively larger than the rest of the body, and vasculature is easily disrupted, hence the higher risk of epidural and subdural haematoma. Syncope is by far the most common cause with a lifetime incidence of about 40%. Orthostatic hypotension denotes fall of blood pressure (BP) on standing. Neurogenic orthostatic hypotension is due to impaired sympathetic activation with a fall in BP with little or no increase in heart rate. In neonatal seizures, subsequent developmental delay, cerebral palsy, epilepsy and death are related to low Apgar scores at 5 minutes. Focal seizures are often more serious than generalised seizures. Focal seizures can be the presenting features of herpes encephalitis or cerebral tumours.
