Traumatic extradural hematomas of the posterior fossa in children

Clarà, J. M. Costa; Claramunt, E.; Ley, L.; Lafuente, Jesús

doi:10.1007/bf00266818

Cited by 20 publications

(11 citation statements)

References 17 publications

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“…A number of studies on PFEDH can be found in the literature; however, exclusively pediatric case series are fewer in number [1,2,3,6,7,8,9,10]. To date, reports of around 140 pediatric cases have been published in English [2].…”

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%

See 2 more Smart Citations

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: 99%

Section: Introductionmentioning

confidence: 94%

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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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“…[37] In about 80% of cases, there is an occipital fracture. [38] Because of the risk of rapid clinical deterioration due to brainstem compression, timely surgery can be life-saving.…”

Section: Introductionmentioning

confidence: 99%

Pediatric head trauma

Alexiou

Sfakianos

Prodromou

2011

J Emerg Trauma Shock

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“… 12 Although some patients have been successfully treated with conservative approach, 5 , 13 most studies support timely management of PFEDH by surgical intervention in children. 5 , 7 , 14 , 15 , 16 , 17 For EDH, standard craniotomy is routinely used to remove the hematomas. 18 There are also several reports on the successful applications of trephination mini-craniectomy for evacuation/drainage of the hematomas in adult patients under emergency setting.…”

Section: Introductionmentioning

confidence: 99%

Trephination mini-craniectomy for traumatic posterior fossa epidural hematomas in selected pediatric patients

Huang

You

Yang

et al. 2017

Chinese Journal of Traumatology

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PurposePosterior fossa epidural hematomas (PFEDH) are uncommon in children but usually require timely surgical intervention due to the risk of life-threatening brainstem compression. We attempt to make the surgical procedure less invasive by treating selected pediatric patients with trephination mini-craniectomy.MethodsWe retrospectively reviewed the clinical courses, radiological findings, surgical procedures, and prognoses of the pediatric patients who were treated in our departments for traumatic PFEDH from January 2010 to January 2015.ResultsDuring this period, a total of 17 patients were surgically treated for PFEDH and 7 were managed with trephination mini-craniectomy for hematoma evacuation. The outcomes were good in all 7 patients as evaluated with Glasgow Outcome Score. There was no mortality in this series. The on average 30-month clinical follow-up showed that patients experienced satisfactory recoveries without complications.ConclusionOur results suggest that trephination mini-craniectomy is a safe surgical technique for selected PFEDH patients with moderate hematoma volume and stabilized neurological functions. However, standard craniectomy is recommend when there are rapid deteriorations in patients' neurological functions or the hematomas are large and exerted severe mass effects.

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Traumatic extradural hematomas of the posterior fossa in children

Cited by 20 publications

References 17 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

Pediatric head trauma

Trephination mini-craniectomy for traumatic posterior fossa epidural hematomas in selected pediatric patients

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