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

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.

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

[2]  Dong-won Kim,et al.  Our Experience with Surgically Treated Epidural Hematomas in Children , 2012, Journal of Korean Neurosurgical Society.

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

[4]  A. Sencer,et al.  Traumatic epidural hematomas of the posterior cranial fossa. , 2008, Surgical neurology.

[5]  N. Malik,et al.  Posterior fossa extradural hematoma: our experience and review of the literature. , 2007, Surgical neurology.

[6]  B. Walters,et al.  Surgical management of posterior fossa mass lesions. , 2006, Neurosurgery.

[7]  C. W. Wong,et al.  The CT criteria for conservative treatment — but under close clinical observation — of posterior fossa epidural haematomas , 2005, Acta Neurochirurgica.

[8]  U. Neubauer.  Extradural haematoma of the posterior fossa. Twelve years experiences with CT-scan , 2005, Acta Neurochirurgica.

[9]  Edson Bor-Seng-Shu,et al.  Epidural hematomas of the posterior cranial fossa. , 2004, Neurosurgical focus.

[10]  J. Lafuente,et al.  Traumatic extradural hematomas of the posterior fossa in children , 1996, Child's Nervous System.

[11]  S. Georgescu,et al.  Posterior fossa extradural hematomas in children: report of nine cases , 1993, Child's Nervous System.

[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]  M. Bozbuğa,et al.  Posterior fossa epidural hematomas: observations on a series of 73 cases , 1999, Neurosurgical Review.

[14]  E. Wang,et al.  Traumatic posterior fossa extradural haematomas (PFEDH). , 1998, Singapore medical journal.

[15]  T. N. Lui,et al.  Epidural hematomas in the posterior cranial fossa. , 1993, The Journal of trauma.

[16]  Y. Erşahin,et al.  Posterior fossa extradural hematomas in children. , 1993, Pediatric neurosurgery.

[17]  A. Mahapatra,et al.  Posterior fossa extradural hematoma , 1990, Indian pediatrics.

[18]  Takahiko,et al.  Study on cases with posterior fossa epidural hematoma--clinical features and indications for operation. , 1990, Neurologia medico-chirurgica.

[19]  F. Tognetti,et al.  Extradural hematomas of the posterior cranial fossa. Observations on a series of 32 consecutive cases treated after the introduction of computed tomography scanning. , 1989, Surgical neurology.

[20]  T. Tomita,et al.  Posterior fossa epidural hematoma during childhood. , 1984, Neurosurgery.

[21]  R. Garza-Mercado.  Extradural hematoma of the posterior cranial fossa. Report of seven cases with survival. , 1983, Journal of neurosurgery.

[22]  J. Roda,et al.  Posterior fossa epidural hematomas: a review and synthesis. , 1983, Surgical neurology.

[23]  H. Handa,et al.  Epidural hematomas of the posterior fossa in children. , 1983, Child's brain.

[24]  Harwood-Nash Dc,et al.  The significance of skull fractures in children. A study of 1,187 patients. , 1971, Radiology.

[25]  D. Harwood-Nash,et al.  The significance of skull fractures in children. A study of 1,187 patients. , 1971, Radiology.

[26]  R. Hooper.  Extradural hæmorrhages of the posterior fossa , 1954, The British journal of surgery.