Extradural hematoma of the posterior cranial fossa

Abstract

Fourteen cases of an extradural hematoma of the posterior fossa (EDHPF), are presented and the clinical and radiological finds are described. The onset of symptoms was acute in 10 patients and subacute in the other 4. Hematomas occurred in the younger age groups with a clear male predominance. Nine cases had suffered a blow to the head. A fracture of the occipital bone was seen in 86% of the patients. The bleeder could be identified in 10 cases, and in 6 of these the source was a bleeding transverse sinus. The overall mortality was 14.2%, but only patients with an acute course died (20%). All subacute cases survived. This study revealed that the most important factors influencing mortality were late diagnosis and late treatment. Coexisting intracranial lesions had no influence on mortality. According to the literature, there has been a certain decrease in mortality in the acute and subacute course patients since the introduction of computed tomography (CT) scanning. Emphasis is placed on the importance of occipital soft-tissue swelling and occipital fracture as clues to the possible presence of extradural hematomas, and of using the CT in all such patients even if no clinical symptoms are present.

Spontaneous Bilateral Supratentorial Subdural and Retroclival Extradural Hematomas in Association with Cervical Epidural Venous Engorgement

“…Retroclival extradural hematoma is extremely rare and is usually found in severely injured patients 15) . The diagnosis of retroclival extradural hematoma can be easily confirmed by MRI of the brain.…”

“…Spontaneous intracranial subdural hematoma has been infrequently reported in association with coagulopathy, ruptured cerebral aneurysm or arteriovenous malformation 3,12,13,16,19,20) . Spontaneous subdural hematomas of arterial origin are also rarely reported 15,27,28) . Extradural hematoma of the retroclivus is extremely rare and is usually found in severely injured patients 6,9,15) .…”

“…Spontaneous subdural hematomas of arterial origin are also rarely reported 15,27,28) . Extradural hematoma of the retroclivus is extremely rare and is usually found in severely injured patients 6,9,15) . Enlargement of cervical epidural vein are rarely encountered on imaging studies.…”

Trephination mini-craniectomy for traumatic posterior fossa epidural hematomas in selected pediatric patients

“… 15 Occipital bone fractures are quite common (80%) in pediatric PFEDHs 5 , 13 and PFEDHs are more likely to have a venous origin (venous sinus, venous vessels or diploic veins in bone) by bone fractures than arterial origin. 40 Hydrocephalus or ventricular dilation is uncommon in pediatric PFEDHs and its presence might indicate the existence of severe mass effect in the posterior fossa and thus usually associate with poor prognosis. 5 , 13 We presented here the clinical data on the successful application of trephination mini-craniectomy in 7 pediatric patients.…”

Traumatic supra- and infra-tentorial extradural hematoma: Case series and literature review

“…[ 3 ] EDH comprises the most frequent traumatic space-occupying lesion of the posterior fossa. [ 5 ] Hooper classified traumatic posterior fossa EDH as acute, subacute, and chronic, with the beginning of symptoms within the first 21 st h of trauma, between 2 nd and 7 th days after trauma, and later, respectively. [ 3 6 7 ] According to the literature, there has been a certain decrease in mortality in the acute and subacute course patients.…”