Intracranial epidural hematoma after use of a 3-pin head clamp in a pediatric case with posterior fossa tumor and hydrocephalus: A case report

Abstract

The head clamp system is one of the indispensable equipment of neurosurgery in terms of stabilizing the head and positioning it. In addition, in neurosurgery clinics, the use of pin head clamp is required to use the navigation system effectively. In pediatric cases, complications after the use of pins head clamp are rare, as reported in the literature. This paper presents a pediatric patient with posterior fossa tumor and hydrocephalus, who developed depression fracture and epidural hematoma after the use of Mayfield 3-pin clamp head. For this reason, the patient underwent emergency surgery a second time and the epidural hematoma was evacuated to obtain decompression. Epidural bleeding, which is a complication of the pinned clamped head, is frequently described in the literature, often in the pediatric cases accompanied by posterior fossa tumor and hydrocephalus. In this type of pediatric cases, a safe study for the use of pin clamp head is not yet available in the literature.

Lessons Learned about the Mayfield-Type Cranial Fixation System

“…The Mayfield-type system utilizes fixation pins and is a safe equipment extensively utilized in cranial surgeries [2,[4][5][6][7][8][9] and spinal surgeries [1,[10][11][12][13] in adults [1,3,7,10,14] and children [1,4,[15][16][17]. However, it is associated with systemic and intracranial complications: intracranial hypertension [18][19][20], cranial fracture/depression [2,3,6,10,[14][15][16][17][21][22][23][24], epidural hematoma [1,4,7,10,14,15,[17][18][19][20]22,[25][26]…”