title: Posttraumatic Bilateral Epidural Hygroma of the Posterior Cranial Fossa: Case Report and Brief Review of Literature.
abstract: BACKGROUND
  Posttraumatic posterior fossa epidural hygroma is a rare entity, and a clear management has not been established in the medical literature. We present 1 case and review the literature relevant to this unusual entity. The mechanism of formation and management of posterior cranial fossa epidural hygroma are also outlined.
  
  
  METHODS
  A 2-year-old child presented after a rooftop fall injury with symptoms of headache, drowsiness, vomiting, and brief loss of consciousness. Computed tomography scan demonstrated swelling in the left occipital region and epidural hygroma. After conservative management failed, surgical repair of the dura mater was performed. The child was discharged postoperative day 11 in stable condition with marked improvement in occipital swelling.
  
  
  CONCLUSIONS
  It is imperative to consider epidural hygroma in very small children presenting with occipital injury. As a result of loose adhesion of dura mater and internal cranial lamina layers in younger pediatric patients, potential epidural space may be easily created secondary to injury, and small breaches in meningeal integrity near the cisterna magna may favor cerebrospinal fluid leak. During surgery, if watertight repair of a visible dural tear is performed, duro-periosteal hitching or vacuum drain placement may not be required.
authors.affiliation: Department of Neurosurgery, Narayan Medical College and Hospital, Sasaram, Bihar, India.
authors.forename: Jayendra
authors.initials: J
authors.lastname: Kumar
authors.affiliation: Department of Neurosurgery, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
authors.forename: Viraat
authors.initials: V
authors.lastname: Harsh
authors.affiliation: Department of Neurosurgery, The Keck School of Medicine of the University of Southern California, Los Angeles, California, USA.
authors.forename: Ben A
authors.initials: BA
authors.lastname: Strickland
authors.affiliation: Department of Neurosurgery, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India.
authors.forename: Chandra B
authors.initials: CB
authors.lastname: Sahay
authors.affiliation: Department of Neurosurgery, Rajendra Institute of Medical Sciences, Ranchi, Jharkhand, India. Electronic address: dr.anilkumarranchi@gmail.com.
authors.forename: Anil
authors.initials: A
authors.lastname: Kumar
mesh_terms: D001930:Brain Injuries / Q000150:complications / Q000473:pathology* / Q000601:surgery; D002675:Child, Preschool; D003388:Cranial Fossa, Posterior / Q000293:injuries / Q000473:pathology / Q000601:surgery*; D003937:Diagnosis, Differential; D006801:Humans; D008297:Male; D019635:Neurosurgical Procedures / Q000379:methods*; D019651:Plastic Surgery Procedures / Q000379:methods; D013353:Subdural Effusion / Q000209:etiology* / Q000473:pathology / Q000601:surgery*; D016896:Treatment Outcome
keywords: Cerebrospinal fluid; Epidural hygroma; Occipital bone fracture; Posterior cranial fossa