Posterior fossa extradural hematomas in children: report of nine cases

Ciurea, Alexandru Vlad; Nuteanu, L.; Simiónescu, N; Georgescu, S

doi:10.1007/bf00303574

Cited by 28 publications

(31 citation statements)

References 26 publications

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“…Gupta et al [1], in their series of PFEDH in 19 children, reported 1 case of severe disability and 2 of moderate disability. There was 1 mortality and 1 moderate disability each in the report published by Berker et al [9 ]in their series of 16 children with PFEDH. Ciurea et al [9] reported 100% good outcomes in 9 cases of PFEDH, all managed surgically.…”

Section: Discussionmentioning

confidence: 93%

“…There was 1 mortality and 1 moderate disability each in the report published by Berker et al [9 ]in their series of 16 children with PFEDH. Ciurea et al [9] reported 100% good outcomes in 9 cases of PFEDH, all managed surgically. Sencer et al [2 ]also reported 100% good outcomes in their study which included 40 cases.…”

Section: Discussionmentioning

confidence: 93%

“…Studies analyzing the outcome of pediatric patients managed by both these strategies are very few [2]. All cases reported by Gupta et al [1], Berker et al [3], Ersahin and Mutluer [7] and Ciurea et al [9] were managed surgically, each with different criteria. The only other major report apart from our study which analyzed both these categories was that of Sencer et al [2], which concerned 11 patients managed conservatively and 29 managed surgically.…”

Section: Discussionmentioning

confidence: 99%

“…Treatment is urgent surgical evacuation, except occasionally, when it consists of management along conservative lines [1,2]. A few series have reported the outcomes of such traumatic lesions in children [1,2,3,6,7,8,9,10]. The aim of this study was to analyze the outcomes for children with PFEDH who were managed at our apex trauma center and to compare our results with published reports.…”

Section: Introductionmentioning

confidence: 94%

“…In younger children, falls are common, while vehicular accidents are common in older children [1,9,10]. Regarding the timing of hematoma evolution, this can be classified into acute (<24 h), subacute (up to 7 days) and chronic (>7 days) [1,15,16].…”

Section: Discussionmentioning

confidence: 99%

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

et al. 2015

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Introduction: Traumatic posterior fossa extradural hematomas (PFEDH) are rare lesions constituting <10% of all extradural hematomas. Reliance on clinical findings alone is not recommended as these are nonspecific; for all suspicious cases, it is advisable to conduct a CT scan. Only a handful of pediatric studies have been reported analyzing the outcome of such lesions. The aim of our study was to analyze outcomes for children with PFEDH managed at our apex trauma center. Materials and Methods: We conducted a retrospective analysis of pediatric patients (≤18 years) admitted with a diagnosis of traumatic PFEDH from January 2008 to February 2014. Results: Of 22 patients, 16 were managed surgically (group 1) and 6 conservatively (group 2); 1 failed conservative treatment (due to an increased EDH volume). Mean age was 11.7 years (range 2-18 years). Falls were the most common cause of injury. Vomiting and loss of consciousness were the most frequent presenting features. There were 18 mild, 2 moderate and 2 severe head injuries. The mean volume of EDH was 37.1 ml (range 18-100 ml) and 10.3 ml (8-16 ml) in the operative and conservative subgroups, respectively. Occipital bone fracture was seen in 16 cases with supratentorial extension in 11. Four complications were noted in 3 cases. Mean follow-up duration was 25.1 months (range 3-34 months). Except for 1 patient, all had excellent outcomes. There was no mortality. Conclusions: Traumatic pediatric PFEDHs are rare. Both the clinical status of the patient and the volume of the hematoma need to be assessed before deciding on surgery. Most cases have associated occipital bone fractures and around half have supratentorial extension; these need to be carefully assessed preoperatively. Torrential venous bleeding can be a major problem due to rupture of the adjacent sinuses. Timely intervention is crucial for achieving good outcome, keeping in view a low threshold for surgical evacuation. Although not innovative, this second-largest case series provides additional data and contributes to the existing literature on such lesions in pediatric patients.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 94%

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

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

et al. 2015

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Kopfschmerz bei Gefäßstörungen

Göbel

1997

Die Kopfschmerzen

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Traumatic extradural hematomas of the posterior fossa in children

et al. 1996

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The most favorable type of traumatic intracranial bleeding in childhood is the extradural hemorrage (EDH). The posterior fossa location is less frequent than the supratentorial site. In the period from January 1989 to January 1994 we treated 2,372 patients with craniocerebral trauma; 31 had extradural hematomas (1.3%); 3 of them were located in the posterior fossa (9.7%): 1 boy and 2 girls aged from 6 to 16 years. The traumatic mechanism was an occipital fall in all cases. Diagnosis was made by computed tomography scan (CT). Two of them had a rapidly deteriorating course. The three patients were operated on without mortality and there was no morbidity. The role of CT in the early detection of lesions and prompt surgical evacuation may reduce the mortality and morbidity from this lesion. The interaction between these factors is discussed.

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Posterior fossa extradural hematomas in children: report of nine cases

Cited by 28 publications

References 26 publications

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

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

Kopfschmerz bei Gefäßstörungen

Traumatic extradural hematomas of the posterior fossa in children

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