Treatment Results for Traumatic Epidural Hematomas on Posterior Cranial Fossa

ABSTRACT

OBJECTIVE: This study is aimed to evaluate the various clinical characteristics, prognostic factors, and the treatment results in epidural hematomas on posterior cranial fossa. METHODS: Thirty-two patients with posterior fossa epidural hematomas(PFEDH) were managed in our institute from 1992 to 2001. In the same period, 414 patients with traumatic epidural hematomas were surgically treated and among these, 28 cases(6.8%) were PFEDH. Neurological state, findings of computed topography scans, and results of the treatment were evaluated in this study. RESULTS: The patients' ages ranged from 4 to 60 years, with predominance in adolescents. The male to female ratio was 3 1. Twenty-nine patients presented with occipital trauma and twenty-eight cases had fracture in occipital bone. Fourteen patients suffered immediate unconsciousness and 6 patients with initial alert mentality experienced delayed progressive loss of consciousness. However, there were no changes on mentality in 12 cases. In 14 cases, the hematoma was localized exclusively within the posterior cranial fossa. In remaining 18 cases, the hematoma extended beyond the sinuses to the occipital area. In 13 cases, the amount of hematoma was increased in follow-up computed tomographic scan. All patients, managed with surgery or conservative treatment(4 cases), survived with a good recovery. CONCLUSION: The most important prognostic factor is prompt surgical evacuation of hematomas. For attaining good result, earlier diagnosis with consecutive computed tomographic scans are much important.