<I>Study on Cases with Posterior Fossa Epidural Hematoma</I>

Abstract

In this retrospective study, 11 cases of posterior fossa epidural hematoma were analyzed in terms of clinical and radiological features, treatment, and outcome. Posterior fossa epidural hematomas accounted for 11.8% of all epidural hematomas encountered during the 7-year period studied. There were eight males and three females ranging in age from 2 to 53 years (mean, 20.7 years). Glasgow Coma Scale scores on admission were relatively good in many cases. Headache and/or vomiting were common symptoms on admission, whereas cerebellar signs were rare. As all 11 cases involved trauma, occipital fractures were present in eight (72.7%). Six patients underwent surgery. The indications for surgery, in terms of computed tomography findings, were: 1) the maximum thickness of the epidural hematoma was more than 15 mm; 2) the posterior fossa cisterns (e.g., the quadrigeminal and ambient cisterns) were poorly visualized; 3) there was marked deformity and/or displacement of the fourth ventricle; and 4) the hematoma extended to the supratentorial region and severely compressed the brain. At discharge, eight patients showed good recovery and one was moderately disabled. Two patients died. The prognosis for posterior fossa epidural hematoma appears relatively good, if it is not accompanied by severe primary brainstem injury and is diagnosed early, and appropriately and promptly treated.

Traumatic Pediatric Posterior Fossa Extradural Hematomas: A Tertiary-Care Trauma Center Experience from India

“…There are no stringent criteria for deciding on the type of management; however, a few characteristics mentioned below can guide clinicians in this aspect. Many authors have taken into consideration different criteria for surgical evacuation including a volume >10 ml, >5 mm/>15 mm thickness of hematoma, a midline shift >5 mm, obliteration of perimesencephalic cisterns, displacement of the fourth ventricle and the presence of hydrocephalus [1,2,4,5,7,18,22,23,24]. We believe that the presence of a fourth-ventricular mass effect is sufficient to label the case as significant and operative, as this encompasses both the volume and thickness of the hematoma itself.…”

Retroclival Pneumocephalus Associated with Bilateral Abducens Palsy in a Child

“…TBI causing posterior fossa lesions is uncommon but, recently, more cases have been diagnosed because of the better quality of and easier access to CT [5]. Smaller lesions, in contrast to supratentorial lesions, may have a bad outcome because they can compress important structures housed in the infratentorial compartment, e.g.…”

Epidural hematoma with detachment of the dural sinuses

“…[12610111213] Yilmazlar et al . [12] described a frequency of 25% of nonarterial EH in their series of 30 patients, among whom 60% were caused by rupture of dural sinuses.…”

“…[891011] Jamieson et al . [1] reported three cases of “vertical extradural hematoma” in their series, but they do not specify if the EH involved the supra- and the subtentorial space.…”