Journal of Korean Neurosurgical Society

The Korean Neurosurgical Society (대한신경외과학회)
권호 표지
DOI QR코드

DOI QR Code

Traumatic Posterior Fossa Epidural Hematomas in Children : Experience with 48 Cases and a Review of the Literature

  • You, Chaoguo (Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University) ;
  • Long, Xiu (Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University) ;
  • Hu, Liuxun (Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University) ;
  • Sheng, Hansong (Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University) ;
  • Zhang, Nu (Department of Neurosurgery, The Second Affiliated Hospital and Yuying Children's Hospital of Wenzhou Medical University)
  • Received : 2016.06.02
  • Accepted : 2017.01.09
  • Published : 2019.03.01
Download PDF
⟨ Previous Next ⟩

Abstract

Objective : Epidural haematoma (EDH) most commonly occurs in the supratentorial area, particularly in the temporal region, of the brain. Posterior fossa epidural haematoma (PFEDH) is less frequently observed, accounting for only 1.2% to 12.9% of all EDH cases. Because of the non-specific symptoms and the potential for rapid and fatal deterioration in children, an early computed tomography (CT) scanning is necessary for all suspicious cases. The aim of the present study was to share the experience of 48 cases and review the literature concerning PFEDH. Methods : A retrospective analysis was conducted for 48 paediatric cases diagnosed with PFEDH and admitted to Yuying Children's Hospital of Wenzhou Medical University from January 2010 to August 2015. The clinical features and outcomes were analyzed and compared with previous literature. Results : Seventeen patients were surgically treated in this series and 31 patients received non-operative treatment. The outcomes were good in 46 patients, evaluated using the Glasgow outcome score (GOS), while mild disability was observed in one patient, and only one case showed severe disability. There were no cases of mortality in this series. Conclusion : Posterior fossa epidural haematoma is relatively rare compared with supratentorial epidural haematoma. Early and serial CT scans should be performed for all suspicious cases. The criteria for the surgical treatment of paediatric patients with PFEDH were concluded. The overall prognosis was excellent in paediatric patients.

Keywords

References

  1. Ammirati M, Tomita T : Posterior fossa epidural hematoma during childhood. Neurosurgery 14 : 541-544,1984 https://doi.org/10.1227/00006123-198405000-00002
  2. Berker M, Cataltepe O, Ozcan OE : Traumatic epidural haematoma of the posterior fossa in childhood: 16 new cases and a review of the literature. Br J Neurosurg 17 : 226-229, 2003 https://doi.org/10.1080/0268869031000153071
  3. Bor-Seng-Shu E, Aguiar PH, de Almeida Leme RJ, Mandel M, Andrade AF, Marino R Jr : Epidural hematomas of the posterior cranial fossa. Neurosurg Focus 16 : ECP1, 2004
  4. Bozbuga M, Izgi N, Polat G, Gurel I : Posterior fossa epidural hematomas: observations on a series of 73 cases. Neurosurg Rev 22 : 34-40, 1999 https://doi.org/10.1007/s101430050006
  5. Bullock MR, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell DW, et al. : Surgical management of posterior fossa mass lesions. Neurosurgery 58 : S47-S55; discussion Si-Siv, 2006
  6. Ciurea AV, Nuteanu L, Simionescu N, Georgescu S : Posterior fossa extradural hematomas in children: report of nine cases. Childs Nerv Syst 9 : 224-228, 1993 https://doi.org/10.1007/BF00303574
  7. Costa Clara JM, Claramunt E, Ley L, Lafuente J : Traumatic extradural hematomas of the posterior fossa in children. Childs Nerv Syst 12 : 145-148, 1996 https://doi.org/10.1007/BF00266818
  8. Ersahin Y, Mutluer S : Posterior fossa extradural hematomas in children. Pediatr Neurosurg 19 : 31-33, 1993 https://doi.org/10.1159/000120697
  9. Garza-Mercado R : Extradural hematoma of the posterior cranial fossa. Report of seven cases with survival. J Neurosurg 59 : 664-672, 1983 https://doi.org/10.3171/jns.1983.59.4.0664
  10. Gupta PK, Mahapatra AK, Lad SD : Posterior fossa extradural hematoma. Indian J Pediatr 69 : 489-494, 2002 https://doi.org/10.1007/BF02722650
  11. Harwood-Nash DC, Hendrick EB, Hudson AR : The significance of skull fractures in children. A study of 1,187 patients. Radiology 101 : 151-156, 1971 https://doi.org/10.1148/101.1.151
  12. Hooper RS : Extradural haemorrhages of the posterior fossa. Br J Surg 42 : 19-26, 1954 https://doi.org/10.1002/bjs.18004217103
  13. Jung SW, Kim DW : Our experience with surgically treated epidural hematomas in children. J Korean Neurosurg Soc 51 : 215-218, 2012 https://doi.org/10.3340/jkns.2012.51.4.215
  14. Karasu A, Sabanci PA, Izgi N, Imer M, Sencer A, Cansever T, et al. : Traumatic epidural hematomas of the posterior cranial fossa. Surg Neurol 69 : 247-251; dicussion 251-252, 2008 https://doi.org/10.1016/j.surneu.2007.02.024
  15. Lui TN, Lee ST, Chang CN, Cheng WC : Epidural hematomas in the posterior cranial fossa. J Trauma 34 : 211-215, 1993 https://doi.org/10.1097/00005373-199302000-00005
  16. Malik NK, Makhdoomi R, Indira B, Shankar S, Sastry K : Posterior fossa extradural hematoma: our experience and review of the literature. Surg Neurol 68 : 155-158; discussion 158, 2007 https://doi.org/10.1016/j.surneu.2006.10.051
  17. Mori K, Handa H, Munemitsu H, Oda Y, Hashimoto N, Kojima M : Epidural hematomas of the posterior fossa in children. Childs Brain 10 : 130-140, 1983
  18. Neubauer UJ : Extradural haematoma of the posterior fossa. Twelve years experiences with CT-scan. Acta Neurochir (Wien) 87 : 105-111, 1987 https://doi.org/10.1007/BF01476060
  19. Otsuka S, Nakatsu S, Matsumoto S, Sato S, Motozaki T, Ban S, et al. : Study on cases with posterior fossa epidural hematoma--clinical features and indications for operation. Neurol Med Chir (Tokyo) 30 : 24-28, 1990 https://doi.org/10.2176/nmc.30.24
  20. Pozzati E, Tognetti F, Cavallo M, Acciarri N : Extradural hematomas of the posterior cranial fossa. Observations on a series of 32 consecutive cases treated after the introduction of computed tomography scanning. Surg Neurol 32 : 300-303, 1989 https://doi.org/10.1016/0090-3019(89)90234-6
  21. Prasad GL, Gupta DK, Sharma BS, Mahapatra AK : Traumatic pediatric posterior fossa extradural hematomas: a tertiary-care trauma center experience from India. Pediatr Neurosurg 50 : 250-256, 2015 https://doi.org/10.1159/000438488
  22. Roda JM, Gimenez D, Perez-Higueras A, Blazquez MG, Perez-Alvarez M : Posterior fossa epidural hematomas: a review and synthesis. Surg Neurol 19 : 419-424, 1983 https://doi.org/10.1016/0090-3019(83)90138-6
  23. Sencer A, Aras Y, Akcakaya MO, Goker B, Kiris T, Canbolat AT : Posterior fossa epidural hematomas in children: clinical experience with 40 cases. J Neurosurg Pediatr 9 : 139-143, 2012 https://doi.org/10.3171/2011.11.PEDS11177
  24. Wang EC, Lim AY, Yeo TT : Traumatic posterior fossa extradural haematomas (PFEDH). Singapore Med J 39 : 107-111, 1998
  25. Wong CW : The CT criteria for conservative treatment--but under close clinical observation--of posterior fossa epidural haematomas. Acta Neurochir (Wien) 126 : 124-127, 1994 https://doi.org/10.1007/BF01476421

Cited by

  1. Unusual Case of Posterior Fossa Extradural Hematoma in a Child: Review of the Literature vol.55, pp.6, 2019, https://doi.org/10.1159/000511906
  2. Clinical guidelines for traumatic brain injuries in children and boys vol.30, pp.1, 2020, https://doi.org/10.4081/ejtm.2019.8613
  3. Management of traumatic posterior fossa epidural hematomas in pediatrics: our experience and review of the literature vol.37, pp.9, 2021, https://doi.org/10.1007/s00381-021-05248-y