Traumatic retroclival epidural hematoma - a pediatric entity?
BACKGROUND
Traumatic retroclival epidural hematoma is very rare and only a few cases are described in literature. All previous cases occurred in the pediatric population and were classically seen in pedestrians or cyclists hit by speeding motor vehicles. It is probable that horizontal articulation between the cranium and the atlas and ligamentous laxity at the craniocervical junction in this age group predispose them to ligamentous injury at the craniospinal junction and formation of retroclival hematoma. MRI or three-dimensional reconstructed CT is considered essential for diagnosing this condition. Conservative treatment is an option if neurological deficits are mild and brainstem compression is not significant. Bony fixation is, however, required if there is suspicion of instability.


METHODS
The authors describe the case of an 8-year-old girl who developed traumatic retroclival epidural hematoma after a motor vehicle accident and who was managed conservatively with good recovery.


CONCLUSIONS
This case and the review of literature suggest that retroclival epidural hematoma is a pediatric entity usually associated with ligamental injury at the craniocervical junction.
Division of Pediatric Neurosurgery, Department of Pediatric Surgery, British Columbia's Children's Hospital, Children's and Women's Health Centre, 4480 Oak St, #K3-159, Vancouver, British Columbia V6H 3V4, Canada.
Deepak
D
Agrawal
D Douglas
DD
Cochrane
D001269:Atlanto-Occipital Joint / Q000473:pathology*; D002648:Child; D005260:Female; D016489:Head Injuries, Closed / Q000150:complications; D006407:Hematoma, Epidural, Cranial / Q000175:diagnosis* / Q000209:etiology / Q000473:pathology*; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods; D010372:Pediatrics; D014057:Tomography, X-Ray Computed / Q000379:methods