Posterior fossa acute extradural hematoma in children: Review and management guidelines

Abstract

Posterior fossa acute extradural hematoma is a rare but potentially fatal disease in children. This article reviews the literature on this topic and offers an evidence based guideline for management of the same.

Unusual Case of Posterior Fossa Extradural Hematoma in a Child: Review of the Literature

“…For those reasons, it is not possible to report a more precise incidence of this pathology. PFEH shows a reduced incidence in population [1-3]. Kaushik and Sandip, in an interesting review of the literature on this topic, in the period between 1957 and 2000, found only 157 articles [3].…”

“…PFEH shows a reduced incidence in population [1-3]. Kaushik and Sandip, in an interesting review of the literature on this topic, in the period between 1957 and 2000, found only 157 articles [3]. Chagou et al [1] report that the incidence of PFEH, in a series of 600 pediatric patients was 1.5% while Sencer et al [5] showed a series of 40 cases of pediatric patients with PFEH with an incidence of 8.5%.…”

“…CT scan appears also essential to verify cases characterized by a sudden and rapid clinical deterioration [5]. In cases where CT scan is performed early, it is advisable to repeat CT scan after 6 h to document the possible increase in volume of the hematoma [3, 5]. MR study provides additional information in case of traumas of the dural sinuses and of the brain stem.…”

“…Commonly, occipital trauma is associated with severe headache and vomiting, marked with alterations in the state of consciousness and, only occasionally, a lucid interval. Classically, in the majority of cases, PFEH evolved slowly over a period of 4–8 h, and then, a precipitous deterioration culminating in respiratory arrest occurs [3]. Chaoguo et al [1] report that, in their series, all patients were acute and the majority of them initially presented mild symptoms that gradually progressed.…”

“…The presence of an occipital fracture has been considered the most reliable indicator for the development of hematomas [1]. Occipital linear fractures may be detected in almost 80% of the cases by CT scan [3]. In Chagou’s series, occipital bone fracture was identified in almost 79.2% of the patients evaluated [1].…”