Posterior fossa subdural haematoma associated with anticoagulant therapy

Capistrant, Terrance D.; Goldberg, Ronald N.; Shibasaki, Hatsue

doi:10.1136/jnnp.34.1.82

Cited by 12 publications

(4 citation statements)

References 12 publications

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“…Subdural hematomas form the most common complication of anticoagulation therapy with an incidence of 12-38% [10]. To the best of our knowledge, only six cases of posterior fossa subdural hematoma which are associated with anticoagulation usage have been reported so far in the literature [11][12][13][14][15] (Table 1).…”

Section: Discussionmentioning

confidence: 99%

Bilateral Sub-acute Subdural Hematoma of the Posterior Fossa As a Complication of Anti-coagulation Therapy: A Case Report and Literature Review

Ahmed¹,

Ibrahim²,

Mohammed³

et al. 2022

SJMS

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Background: Subdural hematomas are one of the commonest neurosurgical pathologies faced in practice and it is rarely located in the posterior fossa. Posterior fossa subdural hematomas are challenging because of the difficulty in their diagnosis and management. Case Presentation: A case of bilateral sub-acute subdural hematoma of the posterior fossa in a 65-year-old female presented with a complaint of headache and vomiting for three weeks followed by a decreased level of consciousness two days prior to admission. The patient is a known cardiac patient on long-term anti-coagulant, her condition was intensively investigated and the diagnosis of posterior fossa subacute hematoma was reached, following which the patient was treated surgically and improved in the postoperative period. Conclusion: Subdural hematomas located in posterior fossa are considered very rare. Most of the reported cases are due to anti-coagulant use, with minor number of cases due to trauma. Literature denoted difficulty reaching diagnosis using only computed tomography and advice to be aided by magnetic resonance imaging as in our case. In most occasions, surgical management is the best choice for the management of such a case, regardless of surgical technique, and will result in excellent outcome.

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Section: Discussionmentioning

confidence: 99%

Bilateral Sub-acute Subdural Hematoma of the Posterior Fossa As a Complication of Anti-coagulation Therapy: A Case Report and Literature Review

Ahmed¹,

Ibrahim²,

Mohammed³

et al. 2022

SJMS

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show abstract

“…Before the introduction of CT, most subdural hematomas in the posterior fossa were diagnosed intraoperatively or upon autopsy. [ 3 4 ] The diagnosis of pCSH is particularly difficult in adults; pCSH due to acute subdural hematoma and birth trauma has been reported. [ 4 ] As shown in Table 1 , the number of patients with a preoperative diagnosis of pCSH has increased in the CT era ( n = 13, including our patients).…”

Section: Discussionmentioning

confidence: 99%

Bilateral posterior fossa chronic subdural hematoma treated with craniectomy: Case report and review of the literature

et al. 2016

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Background:Posterior chronic subdural hematomas (pCSHs) are rare. Their diagnosis and treatment are difficult.Description:A 69-year-old woman was admitted to our hospital with nausea, headache, and mild consciousness disturbance. Computed tomography and magnetic resonance imaging showed bilateral pCSH. To prevent further neurological deterioration, we performed surgery under general anesthesia by midline suboccipital craniectomy. Unexpected bleeding from a developed circuitous occipital sinus was stopped with hemoclips. After hematoma removal, she recovered and was transferred to a rehabilitation hospital. By the 19th postoperative day, she had developed no neurologic deficits.Conclusion:This experience demonstrates the risk of blind surgical therapy in patients with pCSH. In such patients, posterior fossa craniectomy may be preferable in terms of diagnosis and safe treatment.

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“…1,2,4,6,[11][12][13]16,18) Burr-hole evacuation and irrigation with or without closed-system drainage has been widely accepted as the optimum method to treat supratentorial CSH, 3,8,14,15,17,19) but the optimal therapeutic strategy for CSH of the posterior fossa is still controversial. Here, we present a case of bilateral CSHs located in the posterior fossae which were successfully treated by posterior fossa trepanation and evacuation of the hematomas.…”

Section: Introductionmentioning

confidence: 99%

Bilateral Chronic Subdural Hematomas of the Posterior Fossae

Kurisu

Kawabori

Niiya

et al. 2012

Neurol. Med. Chir.(Tokyo)

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An 86-year-old female presented with rare bilateral chronic subdural hematomas (CSHs) of the posterior fossae which were successfully treated by surgical intervention. She had experienced mild head trauma one month before admission. She was transferred to our hospital because of consciousness disturbance and tetraparesis. Magnetic resonance (MR) imaging showed simultaneous occurrence of supratentorial and infratentorial CSHs. We tried to evacuate the CSHs of the bilateral posterior fossae because brainstem compression was markedly severe. Through bilateral burr-hole trepanations, chocolate-colored fluid, not containing clotted components, gushed out under great pressure. Postoperative course was uneventful. MR imaging revealed that the CSHs of the posterior fossae had completely disappeared and brainstem compression had also improved. The patient's neurological deficits were immediately improved after the operation. The patient was discharged one month after the operation for further rehabilitation. Trepanation and evacuation of the hematoma through the posterior fossa might be one of the therapeutic options for posterior fossa CSH, which is similar to supratentorial CSH. However, we considered that the emergency of this rare entity and the method of anesthesia were quite different from supratentorial CSH.

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Posterior fossa subdural haematoma associated with anticoagulant therapy

Cited by 12 publications

References 12 publications

Bilateral Sub-acute Subdural Hematoma of the Posterior Fossa As a Complication of Anti-coagulation Therapy: A Case Report and Literature Review

Bilateral Sub-acute Subdural Hematoma of the Posterior Fossa As a Complication of Anti-coagulation Therapy: A Case Report and Literature Review

Bilateral posterior fossa chronic subdural hematoma treated with craniectomy: Case report and review of the literature

Bilateral Chronic Subdural Hematomas of the Posterior Fossae

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