Traumatic cerebellar hematoma in paediatric patient – a case report and review of literature

Kulshreshtha, Vardan; Tripathi, Praveen Kumar; Jaiswal, Gaurav; Gupta, Tarun

doi:10.1515/romneu-2016-0092

Cited by 3 publications

(4 citation statements)

References 3 publications

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“…[1,4,5,9,13,14,17,18] Cerebellar contusions have been described to be less common in children than adults. [12,14] is study had an overall incidence rate of cerebellar contusions in pediatric patients of 0.6%, which is comparable to previously reported literature. e decreased area of the cisterna magna and the size of the contusion were two posterior morphological factors that were heavily correlated to the outcome.…”

Section: Discussionsupporting

confidence: 87%

Prognostic and morphological factors in pediatric cerebellar contusions

Morgan,

Kharbat,

Youssi

et al. 2024

Surgical Neurology International

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Background: Although uncommon, cerebellar contusions are associated with significant morbidity and mortality. Literature is lacking in the prognostic and morphological factors relating to their clinical picture and outcomes, especially within children. The objective of this study is to evaluate prognostic and anatomic factors in the clinical picture of cerebellar contusions, including effacement of the 4th ventricle and cisterna magna. Methods: This is a retrospective chart review over 11 years across two medical centers. Patients included were under 18 years who presented with a cerebellar contusion. Patients were stratified within the study group based on discharge Glasgow outcome scale (GOS) and reviewed for prognostic factors contributing to outcome. Mid sagittal area of the 4th ventricle and cisterna magna were measured using magnetic resonance imaging and compared within the groups. Results: A total of 21 patients met the study criteria, of which 16 (76.2%) were male, with an average patient age of 8.65 years. Poor outcome at discharge (GOS <4) was associated with decreased admission Glasgow coma scale (P = 0.003), admission motor response (P = 0.006), pupil reactivity (P = 0.014), presence of concomitant subarachnoid hemorrhage (P = 0.010), contusion volume (P < 0.001), and decreased area of the cisterna magna (P = 0.012). Patients with poor outcomes were also more likely to require surgical intervention (P = 0.042). Conclusion: There are multiple prognostic factors associated with the overall outcome following cerebellar contusions. The rate of good outcomes in this study was superior to that in previous studies in adults.

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Section: Discussionsupporting

confidence: 87%

Prognostic and morphological factors in pediatric cerebellar contusions

Morgan,

Kharbat,

Youssi

et al. 2024

Surgical Neurology International

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“…[ 7 ] Posterior fossa hematoma is rare in children and the incidence of cerebellar hematoma is much rarer. [ 9 ]…”

Section: Discussionmentioning

confidence: 99%

“…[7] Posterior fossa hematoma is rare in children and the incidence of cerebellar hematoma is much rarer. [9] Asymptomatic traumatic cerebellar hematoma may undergo sudden deterioration of the neurological status which may be attributed to small reserve capacity of the posterior fossa. [10] Cerebellar contusions/hematoma presents in a variety of ways.…”

Section: Discussionmentioning

confidence: 99%

Traumatic cerebellar hematoma: A tertiary care experience of 23 conservatively managed cases

2020

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Context: Traumatic cerebellar hematomas are rare in comparison to nontraumatic cerebellar hematomas. Aims: The aim of this study is to evaluate the prognostic factors and outcome determining factors with regard to conservatively managed isolated traumatic cerebellar hematoma. Settings and Design: Retrospective cohort study. Materials and Methods: A retrospective study of 23 patients of conservatively managed isolated posterior fossa hematoma, admitted between August 2018 and May 2020, was conducted in the Department of Neurosurgery, Institute of Medical Sciences, Banaras Hindu University, Varanasi. Each of the patients was evaluated in terms of age, sex, mode of injury, clinical presentation, comorbidity, the severity of injury, best motor response, Glasgow Coma Scale (GCS) at admission, computed tomography findings, and Glasgow Outcome Scale at discharge/death. Statistical Analysis: Chi-square test and unpaired t -test were used. P < 0.05 was deemed statistically significant. Results: Mean volume of posterior fossa contusion was 8.9 ml. The cerebellar hemispheric (60.9%) location of hematoma was more common. Age at presentation ( P = 0.0086), best motor response ( P < 0.0001), severity of injury ( P = 0.0002), GCS at admission ( P < 0.0001), effacement of basal cistern ( P < 0.0001), fourth ventricular compression and intraventricular hemorrhage ( P = 0.0008), presence of hydrocephalus ( P = 0.0142), subarachnoid hemorrhage ( P = 0.0008), and volume of posterior fossa contusion ( P = 0.0002) were significantly associated with outcome of posterior fossa contusion. Conclusion: Traumatic cerebellar hematoma is rare. Conservatively managed cerebellar hematoma patients must be monitored closely for neurological and radiological status. Patients who show deterioration in neurological or radiological status require surgical intervention.

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“…Posterior fossa hematoma is rare in children and incidence of cerebellar hematoma is much rarer. 22 Most frequent mode of injury is fall followed by road traffic accident. 23 Trauma is a leading cause of childhood head injury, with Center for Disease Control, stating about half a million emergency department visits in the United States is for traumatic brain injury for children aged 0 to 14 years, with 0 to 4 years being the most vulnerable group.…”

Section: Discussionmentioning

confidence: 99%

Traumatic Posterior Fossa Hematoma, A Rare Entity: Study of 21 Cases

Bhardwaj

Sharma

et al. 2019

Journal of Neurosciences in Rural Practice

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Background Traumatic posterior fossa hematoma is a rare entity. Traumatic posterior fossa hematomas are associated with considerable morbidity and mortality and their surgical management remained controversial. Methods From August 2011 to August 2017, approximately 5,100 patients with head injury were managed. Authors reviewed clinical and radiological findings, management criteria, and outcome of posterior fossa hematoma in 21 patients. Results Out of 21 cases, 13 survived with our management. The Glasgow Coma Scale (GCS) on admission was higher in favorable group than in poor outcome group. Factors associated with Glasgow Outcome Scale in two groups were status of fourth ventricle, basal cisterns, subarachnoid hemorrhage (SAH), hematoma volume, and their location (hemispheric or midline). Similarly, associated supratentorial lesions, age, gender, lesions in other parts of body, and timing from injury to reporting to hospital were taken into consideration. Conclusion The factors correlated with patient outcome were age, sex, mode of injury, GCS at admission, associated intracranial hematomas, associated SAH, hematoma volume, hematoma location, basal cisterns, status of fourth ventricle, and associated multiple injuries on other body parts. It is hereby concluded that timely surgical intervention should be employed whenever indicated without delay. Posterior fossa hematomas were rarely observed in the pediatric age group.

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Traumatic cerebellar hematoma in paediatric patient – a case report and review of literature

Cited by 3 publications

References 3 publications

Prognostic and morphological factors in pediatric cerebellar contusions

Prognostic and morphological factors in pediatric cerebellar contusions

Traumatic cerebellar hematoma: A tertiary care experience of 23 conservatively managed cases

Traumatic Posterior Fossa Hematoma, A Rare Entity: Study of 21 Cases

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