Posterior Fossa Extradural Hematomas in Children

Erşahin, Yusuf; Mutluer, Saffet

doi:10.1159/000120697

Cited by 31 publications

(32 citation statements)

References 17 publications

(37 reference statements)

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“…LOC of any degree (transient/persistent) and vomiting were the most common manifestations noted in our series, comparable with other reports [1,2,7,15]. The majority of cases in published series have involved mild head injury (GCS 13-15).…”

Section: Discussionsupporting

confidence: 91%

“…A blow to the occipital region is almost universal [2,7]. Overlying skull-bone fracture is a common feature with these lesions, with the frequency ranging from 40 to 87%, even though <10% of patients are known to have PFEDH [1,2,6,17,18].…”

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: 99%

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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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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: Discussionsupporting

confidence: 91%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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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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“…Spontaneous subdural hematomas of arterial origin are also rarely reported 15,27,28) . Extradural hematoma of the retroclivus is extremely rare and is usually found in severely injured patients 6,9,15) . Enlargement of cervical epidural vein are rarely encountered on imaging studies.…”

Section: Introductionmentioning

confidence: 99%

Spontaneous Bilateral Supratentorial Subdural and Retroclival Extradural Hematomas in Association with Cervical Epidural Venous Engorgement

Cho

Park

Chough

et al. 2009

J Korean Neurosurg Soc

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We describe a case of 36-year-old man who presented with a subacute headache preceded by a 1-month history of posterior neck pain without trauma history. Head and neck magnetic resonance imaging (MRI) studies disclosed bilateral supratentorial subdural and retroclival extradural hematomas associated with marked cervical epidural venous engorgement. Cerebral and spinal angiography disclosed no abnormalities except dilated cervical epidural veins. We performed serial follow-up MRI studied to monitor his condition. Patient's symptoms improved gradually. Serial radiologic studies revealed gradual resolution of pathologic findings. A 3-month follow-up MRI study of the brain and cervical spine revealed complete resolution of the retroclival extradural hematoma, disappearance of the cervical epidural venous engorgement, and partial resolution of the bilateral supratentorial subdural hematoma. Complete resolution of the bilateral supratentorial subdural hematoma was confirmed on a 5-month follow-up brain MRI. The diagnosis and possible mechanisms of this rare association are discussed.

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“…5,6,8,12,14 There has been an increase in cases of PFEDH without mass effect treated conservatively with good results. 10,11,15,16,21 …”

mentioning

confidence: 99%

Epidural hematomas of the posterior cranial fossa

Bor-Seng-Shu¹,

Aguiar²,

Leme³

et al. 2004

FOC

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Object The authors present their experience in the management of posterior fossa epidural hematoma (PFEDH), which involved an aggressive diagnostic approach with the extensive use of head computerized tomography (CT) scanning. Methods The authors treated 43 cases of PFEDH in one of the largest health centers in Brazil. Diagnosis was established in all patients with the aid of CT scanning because the clinical manifestations were frequently nonspecific. Cases were stratified by clinical course, Glasgow Coma Scale score, and their radiological status. Based on clinical and radiological parameters the patients underwent surgical or conservative management. Conclusions Compared with outcomes reported in the available literature, good outcome was found in this series. This is primarily due to the broad use of CT scanning for diagnostic and observational purposes, which, in the authors' opinion, led to early diagnosis and prompt treatment.

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Posterior Fossa Extradural Hematomas in Children

Cited by 31 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

Spontaneous Bilateral Supratentorial Subdural and Retroclival Extradural Hematomas in Association with Cervical Epidural Venous Engorgement

Epidural hematomas of the posterior cranial fossa

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