Posterior fossa epidural hematoma: A 6-year management experience

Abstract

Objective: Through this study, we sought to evaluate the management of posterior fossa extradural hematoma (PFEDH).
 Methods: An observational study was conducted at the Neurosurgery Department of Lady Reading Hospital in Peshawar from January 2015 to December 2020. All patients who had a traumatic acute extradural hematoma (EDH) of the posterior fossa were included, irrespective of age and gender. The clinical predictors and outcomes were assessed, including the CT-scan findings and Glasgow Coma Scale (GCS) score.
 Results: A total of 104 cases with posterior fossa extradural hematoma were identified from 1252 extradural hematoma patients admitted during the study period. The mean age of the enrolled patients was 18.17 ± 14.31 years. Most of the patients were male (65.39%) and belonged to the pediatric age group, i.e., < 15 years (60.6%). CT scan brain was done in all the cases for diagnosis. In 68.3% of cases, an associated occipital bone fracture was observed. Surgery was done in almost 71.2% of cases, and most of the patients experienced good recovery after surgery, as indicated by the GOS score. Linear regression model revealed that treatment (β=-0.20, p=0.038), time duration between surgery and trauma (β=0.43, p=0.000) and GCS category (β=-0.47, p=0.000) were significantly associated with PFEDH outcomes.
 Conclusion: In conclusion, PFEDH was frequent among males and the pediatric age group. Serial CT brain is highly recommended in all suspected cases for early diagnosis.
 doi: https://doi.org/10.12669/pjms.39.1.6408
 How to cite this: Sharafat S, Azam F, Khan Z. Posterior fossa epidural hematoma: A 6-year management experience. Pak J Med Sci. 2023;39(1):---------. doi: https://doi.org/10.12669/pjms.39.1.6408
 This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/3.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Delayed presentation of traumatic supra- and infratentorial extradural hematoma: illustrative case

“…Observations Sharafat et al, 10 in their 6-year study of 1252 patients with EDH, found 104 patients to have PFEDH, corresponding to approximately 8% of cases. SIEDH is estimated to be a rarer subtype of PFEDH, with an incidence of less than 2% of all EDHs 1 and 11%-70% of all PFEDHs.…”

“…[3][4][5][6][7][8][9] Prognosis can depend on time delay to surgery and presenting Glasgow Coma Scale (GCS) score. 10 Mortality reported in the literature has ranged from 8% to 26%. 10 Supra-and infratentorial epidural hematoma (SIEDH), a rare subtype of PFEDH, occurs in <2% of all EDHs.…”

“…10 Mortality reported in the literature has ranged from 8% to 26%. 10 Supra-and infratentorial epidural hematoma (SIEDH), a rare subtype of PFEDH, occurs in <2% of all EDHs. 1 SIEDH is clinically important because, although blood can accumulate more slowly, once enough blood has accumulated, rapid compression of the brainstem or fourth ventricle can occur in over 30% of PFEDHs.…”

Traumatic Delayed Posterior Cranial Fossa Epidural Hematoma: A Rare Entity

“…2 The extradural hematomas of the posterior fossa may be categorized as acute or delayed defined with respect to the brain stem compression appearing within or after 24 hours of injury. 3 Surgical evacuation is needed in most of the cases but only few patients can be managed conservatively and some might need surgery later on.…”