[Traumatic posterior fossa hematoma].
The traumatic posterior fossa hematoma was regarded as relatively rare thing, but recently, as the result of the prevalence of CT scanners, the number of reported cases is increasing. We report nine cases of traumatic posterior fossa hematoma. We divided into two categories: one was the acute epidural hematoma, the other was the acute subdural hematoma with cerebellar contusion. Five were cases of the acute epidural hematoma, three were cases of the acute subdural hematoma with cerebellar contusion and a case had both an epidural and a subdural hematoma. All the cases had struck the occipital region and had the occipital bone fracture. The prognosis of the five cases of the acute epidural hematoma was excellent, but that of the four cases of the acute subdural hematoma with cerebellar contusion was poor and they all died inspite of the removal of the hematoma executed in three cases. We estimated that the hitting forth was extremely strong in cases of the subdural hematoma with cerebellar contusion, and that the momentary deformity of the occipital bone might injure the cerebellum directly. Once a hematoma was produced in the posterior fossa, it oppresses the brainstem and causes the acute hydrocephalus, so the state of consciousness and respiration deteriorate suddenly. In cases of the acute epidural hematoma, appropriate surgical intervention could save the patients and resulted in good outcome. But in some cases of the fulminant type acute epidural hematoma of the posterior fossa caused by tearing the sinuses, though we have not experienced, patients die before the diagnosis and treatment.(ABSTRACT TRUNCATED AT 250 WORDS)
Hamasaki
T
T
Department of Neurosurgery, Saisei-kai Shiga-ken Hospital, Japan.
Yamaki
T
T
Yoshino
E
E
Higuchi
T
T
Horikawa
Y
Y
Hirakawa
K
K
D000293:Adolescent; D000368:Aged; D001924:Brain Concussion / Q000150:complications; D002675:Child, Preschool; D003388:Cranial Fossa, Posterior; D005260:Female; D006407:Hematoma, Epidural, Cranial / Q000209:etiology* / Q000601:surgery; D006408:Hematoma, Subdural / Q000209:etiology* / Q000601:surgery; D006801:Humans; D008297:Male; D008875:Middle Aged; D009777:Occipital Bone / Q000293:injuries*; D011379:Prognosis; D012887:Skull Fractures / Q000150:complications*