Acute traumatic Posterior Fossa Subdural Haematomas

Abstract

Acute Posterior Fossa Subdural Haematoma (PFSDH) caused by trauma is a clinical rarity: only 13 cases have been encountered in the literature. Three consecutive personal cases of PFSDH are presented. Two of them are respectively the sixth and the seventh surgically treated cases with success. Among the 16 cases 60% had a sudden clinical worsening within 24 hours. Seven cases had an occipital fracture. Of the thirteen cases operated upon 11 (85%) were in a state of deep coma. The surgical mortality was 46%. One patient had a good recovery (Grade 5) and six a moderate disability (Grade 4) on the Glasgow Outcome Scale. We conclude that surgical treatment must always be carried out even in patients presenting in an agonal state.

Traumatic Hematoma of the Posterior Fossa

“…Additionally, hematoma enlargement was seen in 33 % of PFEDH patients, 10 % of PFSDH patients, and 12 % of those with intracerebellar hematoma, which was in accordance with previous reports [2][3][4][5][6][7]10 ] . Six patients underwent surgery for posterior fossa hematoma within 24 h, and two patients (25 %) underwent surgery 2 or 3 days after injury because of gradual hematoma enlargement.…”

“…Because of their rarity, individual neurosurgeons do not gain much experience in their management. Traumatic posterior fossa hematomas are divided into epidural hematoma (EDH), subdural hematoma (SDH), and intracerebellar hematoma [1][2][3][4][5][6][7][8][9][10][11][12][13] . During a 14-year period, we treated 41 patients with traumatic posterior fossa hematoma, including posterior fossa epidural hematoma (PFEDH), intracerebellar hematoma, and posterior fossa subdural hematoma (PFSDH), and have retrospectively investigated the clinicoradiological features in these patients.…”

Traumatic posterior fossa subdural hematomas

“…3,17 Among these hematomas, SDHs are the most uncommon complication, 3,17 accounting for approximately 0.2% of head-injured patients and 0.3% to 0.8% of all SDHs. 1,2,17 Our case series showed a similar frequency, with a male:female ratio of posterior fossa injury of 45:20 and a mean age of 40 years (age range, 0.5-97 years).…”

“…1,2 Because of their rarity, individual neurosurgeons cannot gain considerable experience in their management. To the best of our knowledge, only 55 cases of posterior fossa SDHs have been reported.…”

“…To the best of our knowledge, only 55 cases of posterior fossa SDHs have been reported. [1][2][3][4][5][6][7][8][9][10][11][12][13][14][15][16] Herein, we report an additional 10 cases of posterior fossa SDHs and review their characteristics.…”