Regarding “Retroclival Epidural Hematomas: A Clinical Series”

Petit, Damien; Mercier, Philippe

doi:10.1227/neu.0b013e31820419a7

Cited by 3 publications

(15 citation statements)

References 22 publications

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“…REDH typically develops after motor vehicle accidents involving the cervical spine [3,4]. To the best of our knowledge, no more than 30 patients have been reported in the literature [3,5] since the initial report by Orrison et al [6]. Thus, the relevance of the present report is stressed by the extremely limited literature in this regard.…”

Section: Introductionmentioning

confidence: 77%

“…REDH comprise rare posterior fossa traumatic lesions that typically affect children [3,4,5]. They seldom occur in adults with occasional cases reported [1,7].…”

Section: Discussionmentioning

confidence: 99%

“…Such a phenomenon may be more pronounced in cases of rupture of the transverse ligament of the atlas after hyperflexion injury, in which posterior dislocation of the odontoid process causes a severe strip of the membrane from the clivus [6]. So, the same mechanism of trauma is believed to be causative of REDH and craniocervical instability, justifying the relatively frequent association in up to 37% of patients [5]. …”

Section: Discussionmentioning

confidence: 99%

“…First, almost all patients experienced the same mechanism of trauma since they were involved in a high-speed motor vehicle accident as a passenger, a pedestrian or a bicyclist [3,4,5,6]. Second, clinical presentation predominantly affects cranial nerves [3,5].…”

Section: Discussionmentioning

confidence: 99%

“…Second, clinical presentation predominantly affects cranial nerves [3,5]. Third, the outcome is generally satisfactory with conservative treatment [1,3,5]. …”

Section: Discussionmentioning

confidence: 99%

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Retroclival Epidural Hematoma in a Child Affected by Whiplash Cervical Injury: A Typical Case of a Rare Condition

Souza

Aguiar²,

Santos³

et al. 2011

Pediatr Neurosurg

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Traumatic posterior fossa epidural hematomas are uncommon lesions. Among these lesions, retroclival epidural hematomas (REDH) are particularly rare conditions that usually occur in the pediatric population due to predisposing anatomical features in this patient group. We describe a typical case of traumatic REDH from the mechanism of trauma to outcome. This 8-year-old girl was involved in a motor vehicle accident leading to whiplash cervical injury and cranial nerve palsy. Any children involved in a severe motor vehicle accident with such a sequence of events should raise suspicion for prompt diagnosis.

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Section: Introductionmentioning

confidence: 77%

“…REDH comprise rare posterior fossa traumatic lesions that typically affect children [3,4,5]. They seldom occur in adults with occasional cases reported [1,7].…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

“…Second, clinical presentation predominantly affects cranial nerves [3,5]. Third, the outcome is generally satisfactory with conservative treatment [1,3,5]. …”

Section: Discussionmentioning

confidence: 99%

See 3 more Smart Citations

Retroclival Epidural Hematoma in a Child Affected by Whiplash Cervical Injury: A Typical Case of a Rare Condition

Souza

Aguiar²,

Santos³

et al. 2011

Pediatr Neurosurg

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Retroclival collections associated with abusive head trauma in children

et al. 2014

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Retroclival collections are rare lesions reported almost exclusively in children and strongly associated with trauma. We examine the incidence and imaging characteristics of retroclival collections in young children with abusive head trauma. We conducted a database search to identify children with abusive head trauma ≤ 3 years of age with brain imaging performed between 2007 and 2013. Clinical data and brain images of 65 children were analyzed. Retroclival collections were identified in 21 of 65 (32%) children. Ten (48%) were subdural, 3 (14%) epidural, 2 (10%) both, and 6 (28%) indeterminate. Only 8 of 21 retroclival collections were identifiable on CT and most were low or intermediate in attenuation. Eighteen of 21 retroclival collections were identifiable on MRI: 3 followed cerebral spinal fluid in signal intensity and 15 were bloody/proteinaceous. Additionally, 2 retroclival collections demonstrated a fluid-fluid level and 2 enhanced in the 5 children who received contrast material. Sagittal T1-weighted images, sagittal fluid-sensitive sequences, and axial FLAIR (fluid-attenuated inversion recovery) images showed the retroclival collections best. Retroclival collections were significantly correlated with supratentorial and posterior fossa subdural hematomas and were not statistically correlated with skull fracture or parenchymal brain injury. Retroclival collections, previously considered rare lesions strongly associated with accidental injury, were commonly identified in this cohort of children with abusive head trauma, suggesting that retroclival collections are an important component of the imaging spectrum in abusive head trauma. Retroclival collections were better demonstrated on MRI than CT, were commonly identified in conjunction with intracranial subdural hematomas, and were not significantly correlated with the severity of brain injury or with skull fractures.

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Isolated traumatic retroclival hematoma: case report and review of literature

2016

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BackgroundRetroclival hematomas are a rare entity. The pathology can be categorized into epidural hematoma or subdural hematoma based on the anatomy of the tectorial membrane. Frequently, the etiology is related to accidental trauma, though other mechanisms have been observed, including coagulopathy, non-accidental trauma, and pituitary apoplexy. There have been only 2 prior cases where both epidural and subdural hematoma co-present.Case presentationAn 8-year-old male was involved in a high-speed motor vehicle accident. He presented with a Glasgow Coma Score (GCS) of 14 with bilateral abducens nerve palsies. Computed tomography (CT) revealed a hemorrhage along the dorsum sella, clivus, and dens. Magnetic resonance imaging (MRI) demonstrated the retroclival hematoma in both the subdural and epidural space. At discharge, 19 days after the accident, the abducens nerve palsies had resolved without medical or operative intervention.ConclusionRetroclival hematoma may present after trauma. Although most cases exhibit a benign clinical course with conservative management, significant and profound morbidity and mortality have been reported. Prompt diagnosis with close observation is prudent. Surgical management is indicated in the presence of hydrocephalus, symptomatic brainstem compression, and occipito-cervical instability.

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Regarding “Retroclival Epidural Hematomas: A Clinical Series”

Cited by 3 publications

References 22 publications

Retroclival Epidural Hematoma in a Child Affected by Whiplash Cervical Injury: A Typical Case of a Rare Condition

Retroclival Epidural Hematoma in a Child Affected by Whiplash Cervical Injury: A Typical Case of a Rare Condition

Retroclival collections associated with abusive head trauma in children

Isolated traumatic retroclival hematoma: case report and review of literature

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