Rapid resolution of a traumatic venous epidural hematoma in a 3-year-old child: illustrative case

BACKGROUND Posterior fossa epidural hematoma rarely occurs in children after traumatic head injury. There is ongoing discussion about appropriate treatment, yet the radiological features regarding the time to resorption of the hematoma or required follow-up imaging are rarely discussed. OBSERVATIONS The authors presented the case of a 3-year-old child who was under clinical observation and receiving analgetic and antiemetic treatment in whom near-complete hematoma resorption was shown by magnetic resonance imaging as soon as 60 hours after diagnosis. The child was neurologically stable at all times and showed no deficit after observational treatment. Hematoma resorption was much faster than expected. The authors discussed hematoma drainage via the sigmoid sinus. LESSONS Epidural hematomas in children can be treated conservatively and are resorbed in a timely manner.

[1]  M. Jamous,et al.  Management of traumatic posterior fossa epidural hematomas in pediatrics: our experience and review of the literature , 2021, Child's Nervous System.

[2]  N. Baş,et al.  Management of Traumatic Epidural Hematoma in Infants Younger than One Year: 50 Cases – Single Center Experience , 2021, Pediatric Neurosurgery.

[3]  Daisuke Sakamoto,et al.  Two pediatric cases of epidural hematoma in the posterior fossa with extension along the sigmoid sinus groove: MR evaluation , 2020, Acta radiologica open.

[4]  Zhang Nu,et al.  Traumatic Posterior Fossa Epidural Hematomas in Children : Experience with 48 Cases and a Review of the Literature , 2019, Journal of Korean Neurosurgical Society.

[5]  H. Yin,et al.  Liquid Posterior Fossa Epidural Hematoma in Pediatric Trauma: A Single-Center Case Series , 2018, Journal of Neurological Surgery Part A: Central European Neurosurgery.

[6]  Jian Lin,et al.  Trephination mini-craniectomy for traumatic posterior fossa epidural hematomas in selected pediatric patients , 2017, Chinese journal of traumatology = Zhonghua chuang shang za zhi.

[7]  A. Mahapatra,et al.  Traumatic Pediatric Posterior Fossa Extradural Hematomas: A Tertiary-Care Trauma Center Experience from India , 2015, Pediatric Neurosurgery.

[8]  P. Krishnan.  Late decompensation after a prolonged lucid interval in chronic posterior fossa extradural hematoma. , 2015, Indian pediatrics.

[9]  C. Glasier,et al.  Compression of the posterior fossa venous sinuses by epidural hemorrhage simulating venous sinus thrombosis: CT and MR findings , 2015, Pediatric Radiology.

[10]  Yongming Qiu,et al.  Minimally-invasive aspiration and drainage for management of traumatic epidural hematoma straddling transverse sinus. , 2013, Neurology India.

[11]  A. Sencer,et al.  Posterior fossa epidural hematomas in children: clinical experience with 40 cases. , 2012, Journal of neurosurgery. Pediatrics.

[12]  M. Berker,et al.  Traumatic epidural haematoma of the posterior fossa in childhood: 16 new cases and a review of the literature , 2003, British journal of neurosurgery.

[13]  J. Steno,et al.  [Epidural hematomas in the posterior cranial fossa]. , 1990, Rozhledy v chirurgii : mesicnik Ceskoslovenske chirurgicke spolecnosti.

[14]  G. Besson,et al.  [Angiographic signs of extra-dural hematomas of the posterior fossa (author's transl)]. , 1979, La semaine des hopitaux : organe fonde par l'Association d'enseignement medical des hopitaux de Paris.

[15]  J. Yamashita,et al.  [Vertebral angiography in diagnosis of traumatic hematomas of the posterior fossa (author's transl)]. , 1976, Neurologia medico-chirurgica.