Traumatic posterior fossa subdural hematomas

Takeuchi, Satoru; Takasato, Yoshio; Wada, Koichiro; Nawashiro, Hiroshi; Otani, Naoki; Masaoka, Hiroyuki; Hayakawa, Takanori

doi:10.1097/ta.0b013e31823c89b3

Cited by 16 publications

(7 citation statements)

References 16 publications

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“…Although rare, traumatic posterior fossa ASDHs are often associated with poor outcome. In a retrospective analysis of their experience with 10 patients, Takeuchi and colleagues 9 reported a 90% poor outcome rate and a 50% mortality rate in patients with posterior fossa ASDH. Half of their patients exhibited coagulopathy.…”

Section: Posterior Fossa Acute Subdural Hematomamentioning

confidence: 99%

Natural History of Acute Subdural Hematoma

Vega

Valadka

2017

Neurosurgery Clinics of North America

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Because published guidelines for surgical decision-making in patients with acute subdural hematomas (ASDHs) are based largely on case series and other weak evidence, management often must be individualized. Nonoperative management is a viable option in many cases. The literature is divided about the effects of anticoagulant and antiplatelet medications on rapid growth of ASDHs and on their likelihood of progression to large chronic subdural hematomas. Close clinical and radiologic follow-up is needed, both acutely to detect rapid expansion of an ASDH, and subacutely to detect formation of a large subacute or chronic subdural hematoma.

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Section: Posterior Fossa Acute Subdural Hematomamentioning

confidence: 99%

Natural History of Acute Subdural Hematoma

Vega

Valadka

2017

Neurosurgery Clinics of North America

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“…However, the "spontaneous" development of acute infratentorial (posterior fossa) SDHs is a much rarer event. According to Isla et al [1] Head trauma is the comments cause behind the formation of SDHs in the posterior fossa and in half of those patients, a fracture of the occipital skull bones is found 3 Patients with coagulopathy or bleeding tendency may develop acute SDHs in the posterior fossa in the absence of head trauma [4][5][6][7] .…”

Section: Discussionmentioning

confidence: 99%

Akut Posterior Fossa Subdural Hematom

Amin¹

2014

Cukurova Medical Journal

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Acute posterior fossa subdural hematomas are rare and most of them are trauma-related. Non-traumatic ones have been reported in patients who had idiopathic thrombocytopenic purpura or those who had been receiving anticoagulant therapy. We report on the case of 57-year-old Iranian man who developed sudden severe occipital headache, drowsiness, repeated vomiting, and instability of stance and gait. He was neither hypertensive nor diabetic. No history of head trauma was obtained and he denied illicit drug or alcohol ingestion. A preliminary diagnosis of acute intracerebellar hemorrhage was made. His CT brain scan revealed an acute right-sided, extra-axial, crescent-shaped hyperdense area at the posterior fossa. His routine blood tests, platelets count, bleeding time, and coagulation profile were unremarkable. The patient had spontaneous acute infratentorial subdural hematoma. He was treated conservatively and discharged home well after 5 days. Since then, we could not follow-up him, clinically and radiologically because he went back to Iran. Our patient's presentation, clinical course, and imaging study have called for conservative management, as the overall presentation was relatively benign. Unless the diagnosis is entertained and the CT brain scan is well-interpreted, the diagnosis may easily escape detection. Key Words: acute subdural hematoma; posterior fossa; cerebellar compression; ataxia; spontaneous ÖZET Akut posterior fossa subdural hematom nadir olarak gözlenir ve çoğu travmaya bağlıdır. Travmatik olmayanlar ise antikoagulan tedavi görmüş yada idiopatik trombositopenik purpura hastalarında rapor edilmiştir. Çalışmamızda ani ve ciddi oksipital baş ağrısı ile birlikte halsizlik, tekrarlayan kusmalar, dengesiz duruş ve yürüyüşü olan iranlı 57 yaşındaki bir erkek rapor edilmiştir. Bu kişi hipertansiyon veya diabet hastası değildir. Başında travma geçmişi bulunmamaktadır ve kişi uyuşturucu yada alkol kullanmadığını söylemektedir. Akut intra serebral hemoraji için ön bir tanı yapıldı. CT beyin taraması, posterior fossa bölgesinde sağ taraflı, ekstra aksiyal hilal şeklinde yoğunlaşmış bir alan olduğunu gösterdi.Rutin kan testleri, kanama zamanı, koagülasyon durumu ve trombosit sayımı normaldi. Hastada spontan gelişen akut infratentoryal subdural hematom vardı. Hasta tedavi edildi ve 5 gün sonra iyi bir şekilde taburcu edildi. O zamandan beri hasta klinik olarak veya radyolojik olarak takip edilemedi, çünkü hasta irana geri döndü. Hastanın durumu, klinik seyiri ve görüntüleri konservatif bir yönetim gerektirmiştir. Dolayısıyla genel anlamda hastanın durumu nispeten iyi olsada, CT beyin taramasını iyi yorumlanmadıkça ve olası teşhis konusunda önceden fikir sahibi olunmadıkca hastalık kolayca gözden kaçabilir.Anahtar Kelimeler: Akut subdural hematom, posterior fossa, serebral basınç, spontan, ataksi

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“…Patients who have a posterior fossa subdural hem atoma often have associated fractures of the posterior skull base or occipital condyles. 48 If there is significant posterior fossa mass effect, emergent decompressive surgery may be required. Although CT is the imaging modality of choice, MRI can be help ful, especially when evaluating for smaller contusions or diffuse axonal injury.…”

Section: Intracranial Hemorrhagementioning

confidence: 99%