Traumatic epidural hematomas of the posterior cranial fossa

Karasu, Aykut; Sabancı, Pulat Akın; İzgi, Nail; İmer, Murat; Sencer, Altay; Cansever, Tufan; Canbolat, Ali

doi:10.1016/j.surneu.2007.02.024

Cited by 42 publications

(34 citation statements)

References 23 publications

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“…PFEDH is the most common type of posterior fossa hematoma [ 1,6,7,[9][10][11] . The prognosis is favorable if the appropriate management is performed.…”

Section: Resultsmentioning

confidence: 99%

Traumatic Hematoma of the Posterior Fossa

Takeuchi

Wada

Takasato

et al. 2013

Acta Neurochirurgica Supplement

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Posterior fossa injury is rare, occurring in less than 3 % of head injuries. We retrospectively reviewed patients' clinical and radiological findings, management, and outcomes. The aim of the present study was to investigate the features of posterior fossa hematoma, including posterior fossa epidural hematoma (EDH), posterior fossa subdural hematoma (SDH), and intracerebellar hematoma. From January 1995 to January 2009, 4,315 patients with head trauma were hospitalized at our institution. The -present study focused on 41 patients (1.0 %) with traumatic hematomas of the posterior fossa. Eighteen patients had EDH, 10 patients had SDH, and 17 patients had intracerebellar hematomas. In each type of injury, occipital bone fractures were seen in many patients, and hematoma enlargement was often observed within a few days of the injury. In addition, a high frequency of associated lesions and a high poor outcome rate were features of intracerebellar hematomas and -posterior fossa SDH. The present study suggests that repeat CT imaging and careful management are necessary until the lesion is stabilized, and patients showing lesions with mass effects should therefore be immediately treated with surgery.

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“…PFEDH is the most common type of posterior fossa hematoma [ 1,6,7,[9][10][11] . The prognosis is favorable if the appropriate management is performed.…”

Section: Resultsmentioning

confidence: 99%

Traumatic Hematoma of the Posterior Fossa

Takeuchi

Wada

Takasato

et al. 2013

Acta Neurochirurgica Supplement

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“…8 Finalmente, según su localización craneocaudal; supratentoriales e infratentoriales, siendo estos últimos el 1.2% al 11% de todos los hematomas epidurales. 9 Siendo entonces nuestro caso un hematoma epidural bilateral supratentorial simétrico asincrónico. En cuanto a la formación fisiopatológica de estos Frank et al propusieron en 1982 que el origen de los hematomas epidurales bilaterales es debido a una única fuerza con vector anteroposterior que causa desprendimiento de la duramadre, 10 sin embargo, es probable que esta propuesta aplicaría más para los hematomas epidurales bilaterales frontales y subagudos, puesto que una divergencia en los vectores de fuerza al momento del trauma explicaría los de presentación asincrónica y/o asimétrica.…”

Section: Discussionunclassified

Bilateral Epidural Hematoma: Case Illustration and Classification Proposal

Muñoz¹,

Morán²,

Toro³

et al. 2017

Panamerican Journal of Trauma, Critical Care &Amp; Emergency Surgery

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El hematoma epidural es una complicación frecuente del trauma craneoencefálico cerrado, sin embargo, es infrecuente la presentación de manera bilateral y se asocia a elevada morbimortalidad. Presentamos un caso de paciente masculino de 28 años victima de accidente de transito quien presenta hematoma epidural inicialmente unilateral, y que después de 4 días se convierte en un hematoma epidural bilateral. Source of support: Nil Conflict of interest: None ABSTRACTEpidural hematoma is a frequent complication of closed craneoencephalic trauma, however, bilateral presentation is nonfrequent and it is associated with high morbimortality. We report a case of a male patient who suffered a road traffic accident and has unilateral epidural hematoma, which, after 4 days, becomes bilateral epidural hematoma.

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“…Although the mortality rate of all EDHs has been reported as less than 10%, which is extremely low compared with that of traumatic subdural haematoma, it is difficult to make a diagnosis of posterior cranial fossa EDH because its clinical progress is silent and slow and its symptoms are nonspecific, leading to its becoming incurable and characterised by poor prognosis [10][11][12][13][14][17][18][19]. Indeed, the criminal investigation after the autopsy revealed that the patient had accidentally fallen down stairs in his apartment 10 days before death.…”

Section: Discussionmentioning

confidence: 99%

“…Moreover, his mother had not thought much about the earache because the symptom disappeared the next day. If he had gone to see a physician immediately after the accident because of the earache, and if cranial CT had been performed after the accident during the patient's time in the hospital, the posterior cranial fossa EDH might have been diagnosed before death [12][13][14]. Approximately 60% of EDHs are thought to be of arterial origin, whereas the source of bleeding is venous vessels or diploic veins in bone in 9.7% of all EDHs [10,11].…”

Section: Discussionmentioning

confidence: 99%

“…However, approximately 1% to 3% of short falls causes skull fractures (such as simple linear fractures), less than 1% of which leads to an epidural or subdural hemorrhage [6]. Whereas almost all epidural haematomas (EDHs) may develop due to a laceration in the middle meningeal artery accompanied by a parietal bone fracture, EDHs in the posterior fossa tend to have a venous origin and, even when small in size, may lead to a poor prognosis compared to an ordinary epidural haematoma [8][9][10][11][12][13][14]; nevertheless, to our knowledge, there have been no autopsy cases of EDHs in the posterior fossa in the forensic literature.…”

Section: Introductionmentioning

confidence: 99%

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A subacute epidural haematoma extending over the occipital region and posterior cranial fossa due to a laceration in the transverse sinus

et al. 2011

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A 6-year-old male was found dead on his stomach with massive reddish vomiting from his mouth and nose. Postmortem cranial CT revealed an epidural haematoma in the left occipital region, but the cause and origin of the haematoma were unclear. An autopsy revealed that the epidural haematoma expanded over the left temporal region and the left side of the occipital region and posterior cranial fossa, and its origin was a laceration in the left transverse sinus induced by diastases in the left lambdoidal and occipitomastoid sutures. A pathohistological examination revealed that one portion of the haematoma was an early-stage hemorrhage, while the other portion extended approximately 1 week after the hemorrhage. Moreover, approximately 1 week elapsed after the laceration of the transverse sinus. Thus, we believe that the primary haematoma was induced by the laceration in the transverse sinus approximately 1 week before death, but the haematoma ceased to enlarge due to hemostasis. However, later, the size of the haematoma rapidly increased again due to rebleeding from the laceration, which led to intracranial hypertension. Consequently, we diagnosed the direct cause of death as choking due to vomit aspiration that resulted from intracranial hypertension induced by a subacute epidural haematoma.

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Traumatic epidural hematomas of the posterior cranial fossa

Cited by 42 publications

References 23 publications

Traumatic Hematoma of the Posterior Fossa

Traumatic Hematoma of the Posterior Fossa

Bilateral Epidural Hematoma: Case Illustration and Classification Proposal

A subacute epidural haematoma extending over the occipital region and posterior cranial fossa due to a laceration in the transverse sinus

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