Cerebral Infarction Associated with Acute Subdural Hematoma in Infants: A Rare Entity from Northeastern India
Bibliographic record
Abstract
Purpose: Cerebral infarction associated with acute subdural hematoma (CIASDH) is a rare and devastating entity.Methods: Infants diagnosed with CIASDH between July 2023 and June 2024 were included in this study. The modified pediatric Alberta Stroke Program Early Computed Tomography Score (pedASPECTS) and posterior circulation ASPECTS (pc-ASPECTS) were calculated for each infant. Outcomes were evaluated at 12 months using the modified Rankin scale (mRS) and the Developmental Assessment Scale for Indian Infants.Results: The 17 infants included in the study had a mean±standard deviation age of 3.29±2.23 months, presented with refractory status epilepticus, and exhibited moderate global developmental delay at 12 months. The etiologies of acute subdural hematoma (ASDH) were minor blunt trauma (30%), sepsis-associated coagulopathy (35%), and late-onset hemorrhagic disease of the newborn (HDN) (35%), the latter two being novel etiologies. Infants with HDN had significantly lower mean age and thicker hematomas. The extent of the category 6 infarcts (per the Childhood Arterial Ischemic Stroke [AIS] Standardized Classification and Diagnostic Evaluation criteria) did not differ significantly among the three groups and was not significantly correlated with ASDH severity. The mean pedASPECTS and pc-ASPECTS were 20.65±6.88 and 7.37±1.24, respectively, and these parameters displayed significant moderate correlations with the 12-month mRS. We noted novel radiological findings, including brainstem infarcts, CIASDH associated with falx interhemispheric ASDH, and luxury hyperperfusion.Conclusion: We describe novel etiologies and radiological findings in CIASDH and identify pedASPECTS and pc-ASPECTS scores as prognostic markers of outcome.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.001 |
| Science and technology studies | 0.001 | 0.000 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.000 | 0.001 |
| Research integrity | 0.000 | 0.000 |
| Insufficient payload (model declined to judge) | 0.001 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".