Extradural hematoma of the posterior cranial fossa

Abstract

Extradural posttraumatic posterior fossa hematoma is a rare condition estimated to complicate about 0.3% of all craniocerebral injuries, and represents 4% to 12.9% of the entire group of extradural hematomas. Seven cases of posterior fossa extradural hematoma (PFEDH) are presented. There were four males and three females. One case occurred in an adult, the remaining six cases in patients 16 years of age or younger, two of whom were infants. In each case the hematoma resulted from a blow to the posterior part of the head. Each patient showed local evidence of trauma to the scalp, and a radiographic appearance of an occipital linear fracture crossing the path of the torcular Herophili or the transverse sinus. The clinical picture varied. Three patients suffered immediate transient unconsciousness. Three others suffered sudden respiratory arrest after a seemingly stable course of several hours in the hospital, but responded well to resuscitation maneuvers. Computerized tomography scans were obtained in three patients; in three others no specialized neurodiagnostic studies were feasible; in one patient, precise diagnostic documentation was achieved by Conray ventriculography. All seven patients were operated on and all survived. Two patients had associated surgical intracranial lesions: an underlying subdural hygroma of the posterior fossa in one, and a contralateral supratentorial temporal subdural hematoma in the other. Six patients have returned fully to their previous activities. One patient is steadily improving.

Posterior Fossa Extradural Hematomas in Children

“…PFEHs seem to affect children more than adults [8,10]. A blow to the occipital region is almost always the rule as was observed in all our cases [7.…”

“…However, extradural hematomas are most frequent among traumatic hematomas of the posterior fossa [5,6], Rapid deterioration, which may usually happen after a stable period, and infrequent occurrence make PFEHs very dan gerous. Computed tomography (CT) scanning has made the early diagnosis and prompt surgical treatment of PFEHs possible [7][8][9][10][11][12]. We present 9 cases with PFEH.…”

Traumatic posterior fossa extradural hematoma: case report and review of literature

“…The Incidence is about 0.3% of all craniocerebral injuries, and it represents 4% to 12.9% of the entire group of extradural hematomas. 4 Mortality is high in PFEDH is due to the small volume of the posterior fossa and contained important structures. A high index of suspicion is needed for timely intervention to prevent morbidity and mortality.…”

The prevalence and morphometric features of mastoid emissary vein on multidetector computed tomography

“…Other consequences of emissary vein bleeds are epidural and subdural hematoma formations [6]. Venous anomalies of the internal jugular vein and sigmoid sinus are not uncommon in patients with otitis and labyrinthine dysplasia and may lead to enlargement of the emissary veins [7].…”