Hematoma in the Posterior Fossa Secondary to a Tangential Gunshot Wound of the Occiput: Case Report and Discussion

Abstract

The case of 16-year-old boy who incurred a subdural hematoma in the posterior fossa and an intracerebellar hematoma after a tangential civilian gunshot wound is reported. The skull was not fractured, and yet surgically significant clots required removal. The patient recovered. The discussion centers on the mechanism of injury and seriousness of tangential gunshot wounds and traumatic hematomas in the posterior fossa.

Acute traumatic Posterior Fossa Subdural Haematomas

“…2, 3, 8, 12, 13) in the literature [2,3,5,7,8] and in two of our series, all presenting in extremely poor neurological conditions, we emphasize that prompt surgical treatment should be performed in all patients affected by acute PFSDH, even though moribund, to give them a chance of survival.…”

“…We were able to find in the literature only 13 cases of PFSDH [1][2][3][6][7][8][9], excluding those in the newborn.…”

Suboccipital tangential gunshot wound

“…He noted the rarity of this type of injury as well as the deceiving appearance of the external wound. Stone et al [4] were the first to report in 1991 on a civilian TGSW of the posterior fossa. It must be an extremely rare injury since it remained the only case of posterior fossa TGSW in Stone's large retrospective series of 168 civilian TGSW published recently [5].…”

Traumatic posterior fossa subdural hematomas

“…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.…”