The child needs to be worked up with MRI imaging with and without gadolinium, as well as four vessel angiography, or CT/angiography.
With respect to an idiopathic, or Unknown cause of intracranial hemorrhage, the clot usually resolves over time without surgical intervention if there is no greater than 4 mm of midline shift and if the patient is without frank neurologic deficit.
If there is alteration of mental status, or a neurologic deficit is present, then a neurosurgeon may consider evacuating the clot, after it has been worked up to determine the origin or ideology.
Thank you very much for your time
Jason Garber, M.D., FACS.