Subdural bleeds are diagnosed by CT scan of the brain. Computed tomography scanning requires transporting the neonate. The risk of transportation often raises the possibility of performing a subdural tap in neonates with a suspected subdural collection. Our approach is to not perform a subdural tap based on suspicion. The only exception is in cases when brain ultrasound shows midline shift and lateral brain hemisphere displacement.
Inborn errors of metabolism are tentatively diagnosed based on laboratory investigations that require 3 to 5 days to obtain results. The diagnoses of these disorders are confirmed by enzymatic studies that require several weeks to obtain results. Hence, the need for empirical treatment often arises.