Traumatic Retroclival Epidural Hematoma in a Child -Case Report-

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

“…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].…”

“…Thus, the relatively smaller occipital condyles along with horizontally oriented atlanto-occipital articulations contribute to the lesser stability of the craniovertebral junction. Any posterior dislocation such as that occurring during cervical hyperflexion or hyperextension injuries [3,4] may result in a vascular lesion (e.g. dorsal branch of the meningohypophyseal trunk or basilar venous plexus) due to disruption of the insertion of the tectorial membrane from the clivus ultimately leading to the development of the hematoma in the retroclival area [4,6].…”

“…Any posterior dislocation such as that occurring during cervical hyperflexion or hyperextension injuries [3,4] may result in a vascular lesion (e.g. dorsal branch of the meningohypophyseal trunk or basilar venous plexus) due to disruption of the insertion of the tectorial membrane from the clivus ultimately leading to the development of the hematoma in the retroclival area [4,6]. 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].…”

“…Although the pathogenesis of REDH remains widely controversial [1,3,4,8], there is a general consensus in three issues. 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].…”

“…From 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 [2,3]. 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].…”