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To the Editor.— We read the case report of subdural hemorrhage in an infant with glutaric aciduria type 1 (GA1) by Hartley et al1 with intense interest and wish to make a few pertinent observations about the biomechanics of the infant head. The gross pathology of GA1 is pleomorphic: infant patients are commonly macrocephalic. In some instances the macrocephaly is attributable to megalencephaly.2 In other instances prominence of the subarachnoid spaces (especially of the sylvian fissures) is a factor,3 with or without an additional contribution from chronic or acute subdural hematomas.4 Subcortical …
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Piatt et al. (2002) studied this question.
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