Acute Spontaneous Subdural Hematoma in Posterior Fossa: Great Outcome

Finger, Guilherme; Martins, Otávio Garcia; Basso, Luciano Silveira; Nascimento, Tobias Ludwig do; Schiavo, Felipe Lourenzon; Santos, Samir Cezimbra dos; Stefani, Marco Antônio

doi:10.1016/j.wneu.2018.07.220

Cited by 7 publications

(9 citation statements)

References 11 publications

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“…Posterior fossa ASDH is broadly divided into traumatic and nontraumatic, and most are traumatic. 9 - 11 ) Posterior fossa ASDH is rare with a frequency of less than 3% of head injuries, 12 , 13 ) and it is also reported to have a poor prognosis and a high mortality rate (33%-100%). 12 , 13 ) Although fracture with laceration of the cerebellar cortex seems to be the main mechanism involved in traumatic cases, 12 - 14 ) injury of bridging veins were bleeding origin in some cases.…”

Section: Discussionmentioning

confidence: 99%

“… 12 , 13 ) Although fracture with laceration of the cerebellar cortex seems to be the main mechanism involved in traumatic cases, 12 - 14 ) injury of bridging veins were bleeding origin in some cases. 9 )…”

Section: Discussionmentioning

confidence: 99%

“…Nevertheless, our cases had no obvious traumatic episodes and were considered spontaneous like the cases described previously. 9 , 11 , 15 , 16 ) The causes of nontraumatic posterior fossa ASDH include antithrombotic therapy, cerebrovascular diseases such as arteriovenous malformation, aneurysms, brain tumors, and intracranial hypotension due to spinal drainage or osmotic diuretics. 9 - 11 ) The reported nontraumatic posterior fossa ASDH were 10 cases as far as we searched, and most of them had some kind of blood coagulation abnormality.…”

Section: Discussionmentioning

confidence: 99%

“… 9 , 11 , 15 , 16 ) The causes of nontraumatic posterior fossa ASDH include antithrombotic therapy, cerebrovascular diseases such as arteriovenous malformation, aneurysms, brain tumors, and intracranial hypotension due to spinal drainage or osmotic diuretics. 9 - 11 ) The reported nontraumatic posterior fossa ASDH were 10 cases as far as we searched, and most of them had some kind of blood coagulation abnormality. 1 , 3 , 9 - 11 , 16 - 18 ) In many reported cases, the pathogenic mechanism was considered to be the bridging vein injury in the posterior fossa with minor trauma, and bleeding expanded in a short time with abnormal blood coagulation.…”

Section: Discussionmentioning

confidence: 99%

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Neurosurgical Treatment of Patients with Posterior Fossa Acute Subdural Hematoma Right after Cardiac Surgery

Kikuchi

Orito

Sakata

et al. 2022

Neurol. Med. Chir.(Tokyo)

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As posterior fossa acute subdural hematoma (ASDH) right after cardiac surgery is extremely rare, the clinical course and optimal treatment strategy remain undetermined. We performed a retrospective analysis of patients with posterior fossa ASDH right after cardiac surgery requiring neurosurgical treatment at our institution over a 7-year period and, in this study, discussed the neurosurgical strategy and clinical course. Collected data included clinical history, laboratory results, time course, symptoms, neurosurgical treatment, outcome at discharge, and imaging studies. All six patients were women who had no history of head trauma and had received antithrombotic therapy during the perioperative period of cardiac surgery. All patients showed lower platelets count and were diagnosed with ASDH within 3 days (longest time 64 h) right after cardiac surgery. After discontinuation of anticoagulation therapy and administration of reversal agents, they underwent emergency hematoma evacuation craniotomy (n = 5) or burr hole drainage surgery (n = 1), which were performed in the prone (n = 4) or lateral (n = 2) positions. Four of these patients showed favorable outcomes, and two showed poor outcomes. One of the poor-outcome patients received three antithrombotic therapies, and another developed rapidly progressive ASDH. Posterior fossa ASDH associated with antithrombotic therapy right after cardiac surgery is frequently found in women, and emergent neurosurgical treatment with anticoagulation discontinuation and reversal agent administration can be performed safely. Burr hole drainage surgery might be acceptable in nonsevere cases. By contrast, we must pay attention to cases receiving both anticoagulant and antiplatelet drugs and rapid progression cases.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

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Neurosurgical Treatment of Patients with Posterior Fossa Acute Subdural Hematoma Right after Cardiac Surgery

Kikuchi

Orito

Sakata

et al. 2022

Neurol. Med. Chir.(Tokyo)

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“…Inherited or acquired coagulopathy is usually present in spontaneous central nervous system (CNS) bleeding episodes [26,27,28]. Other systemic pathologies, such as neoplasms, can also be observed [2,[20][21][22].…”

Section: Posterior Fossa Extradural Hematoma (Pfedh)mentioning

confidence: 99%

Non-traumatic epidural posterior fossa hematomas in child with Sensenbrenner syndrome: a case report and literature review

Guimarães¹,

Cardeal²,

Lúcio³

et al. 2021

Arch Pediat Neurosurg

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Background: Posterior fossa extradural hematomas are an uncommon condition with more than half of cases appearing in the pediatric population. Although the majority of cases are caused by substantial trauma, it may also be related to systemic diseases and bleeding disorders without the history of head trauma. Case report: We present the case of a 6-year-old female affected by Sensenbrenner syndrome with a non-traumatic subacute posterior fossa epidural hematoma. The patient was surgically treated and medically discharged without further neurological alteration. This is the first report of spontaneous cerebral hematoma associated with this syndrome in the literature. A literature review of the main aspects of both topics was performed. Conclusions: Although spontaneous posterior fossa epidural hematomas are rare, clinicians should be aware and highly suspicious of this differential diagnosis in certain situations such as coagulopathies and other specific systemic diseases, as fast recognition and assertive treatment are important for better outcomes.

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