Aim: To determine incidence, aetiology, and clinical features of subdural haem atoma and effusion (SDH/E) in infancy throughout the British Isles. Methods: Cas es were notified to the British Paediatric Surveillance Unit over 12 months by p aediatricians, neurosurgeons, and paediatric and forensic pathologists. Results: A total of 186 infants (121 boys, 65 girls) aged 0-2 years were identified. An nual incidence of SDH/E for the UK and Republic of Ireland is 12.54/100 000 aged 0-2 (95%CI 10.3 to 14.62) and 24.1/100 000 aged 0-1 (95%CI 20.89 to 28.18). A total of 106 infants suffered non-accidental head injury (NAHI), 7 accidenta l head injury, 26 a perinatal cause, 7 a non-traumatic medical condition, 23 me ningitis, and in 17 the cause was undetermined; 35 infants died. Significant dif ferences were found in injury pattern, body weight, and Townsend score between N AHI and SDH/E from other cause. There were fewer diagnostic investigations in no n-NAHI cases. Delay in diagnosis of greater than a week occurred in 48/181. Con clusion: SDH/E is a significant cause of morbidity and mortality in infancy. NAH I is the predominant cause of SDH/E. SDH/E can present in a non-specific and va ried way and must be considered in any infant who is unwell. Determining the cau se of the SDH/E in some cases continues to present a diagnostic challenge.
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