Traumatic hematomas of the posterior cranial fossa.

The objective of this study was to find out the result of treatment and the factors which can predict the outcome of traumatic hematomas of the posterior cranial fossa. Twenty two patients with traumatic hematomas of the posterior cranial fossa from 1,500 patients with traumatic intracranial hematomas were analyzed. There were fourteen male and eight female patients. The most common etiology was a motor vehicle accident. About 90 per cent of the patients had a direct injury to the occipital region. Ninety per cent of the patients had an occipital skull fracture or diastatic fracture of the lambdoid suture. The overall mortality rate was about 38 per cent. Patients having pure epidural hematoma had zero mortality. By contrast, patients suffering epidural hematoma with associated intracranial hematoma had 20 per cent mortality. Intracerebellar hematoma led to 60 per cent mortality. Glasgow Coma Scale (GCS) before operation was used to predict the patients' outcome. Ninety per cent of the patients who had a GCS between 13 and 15 had a good recovery. By contrast, only 30 per cent of the patients who had a GCS below 9 had a good recovery. Statistical analysis showed that the GCS value of below 9 predicted the poor outcome for the patients.

The further surgical experiences in intracranial meningiomas at Songklanagarind Hospital.

Meningioma is a common benign intracranial tumor documented in many reports. We retrospectively reviewed 81 patients with a total of 84 meningiomas. There were 61 females and 20 males. Most patients were in the third to sixth decades of life. The most common presenting symptoms were headache and decreased visual acuity. Focal neurological deficits and signs of increased intracranial pressure were found in most patients. The three most common tumor locations were falx and parasagittal, sphenoid wing and convexity. Of the 84 meningiomas, 67 were completely resected and 17 were partially resected. Operative morbidities were accounted for by hemiparesis, cranial nerve palsy and infection. There was only one operative death in our series. 70 patients had normal and good results, 4 patients had severe disabilities and results were unknown in 6 patients. Recurrences were detected in 8 patients and 5 patients underwent surgery again with good results in 4 patients. Recurrences occurred in 3 patients with total and 5 patients with subtotal resections. The most significant factor for recurrence was the extent of tumor resection.