Traumatic posterior fossa hematomas.
OBJECTIVE
Posterior fossa epidural hematomas are much less common than supratentorial epidural hematomas. The incidence of posterior fossa epidural hematomas among intracranial epidural hematomas has been reported to be 4% to 7%. Seven cases of posttraumatic posterior fossa epidural hematomas diagnosed by computed tomography (CT) are reported with radiological and clinical findings.


METHODS
This study consisted of 7 posterior fossa epidural hematoma cases, out of 585 severe head trauma patients admitted and hospitalized in an 18-month period. The patients were evaluated regarding age, gender, type of trauma, cranial CT and Glasgow coma score in admittance, treatment and follow-up.


RESULTS
Average age was 24.2 years and 85.7% of the cases were male. All cases had occipital fracture. Fifty-seven percent of the cases had only occipital fracture and posterior fossa epidural hematoma. All of the cases in this group were neurologically intact except for one who had a Glasgow coma score of 9 in admission. Two cases of this group were conservatively treated. In the others posterior fossa epidural hematomas got larger and they were treated surgically; these two cases recovered after surgery. Three of the 7 cases had the supratentorial region lesions; one of these cases died before operation. Two of them were treated surgically, one of them died and the other showed recovery after surgery.


CONCLUSIONS
Acute posterior fossa epidural hematomas are usually symptom-free initially. After this silent period, clinical deterioration is quick to become fatal in most of patients. Surgery can be life-saving when performed in a timely manner. Therefore, CT should always be performed when an occipital trauma is diagnosed.
Dirim
Berna Vidinli
BV
Department of Radiology, Izmir Atatürk Training and Research Hospital, Izmir, Turkey.
Orük
Cüneyt
C
Erdoğan
Nezahat
N
Gelal
Fazil
F
Uluç
Engin
E
D000293:Adolescent; D000328:Adult; D002648:Child; D003388:Cranial Fossa, Posterior / Q000293:injuries*; D005260:Female; D015600:Glasgow Coma Scale; D006407:Hematoma, Epidural, Cranial / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D006801:Humans; D015601:Injury Severity Score; D008297:Male; D008499:Medical Records; D012189:Retrospective Studies; D012887:Skull Fractures / Q000150:complications / Q000000981:diagnostic imaging / Q000453:epidemiology*; D014057:Tomography, X-Ray Computed; D014421:Turkey / Q000453:epidemiology