Trial of Urokinase in Treatment of Traumatic Vertex and Posterior Fossa Epidural Hematoma

ABSTRACT

We encountered the danger of the bleeding the vertex and posterior fossa epidural hematoma(EDH) operation which were related with large sinuses. Traumatic vertex EDH and posterior fossa EDH were usually accompanied by the fractures of coronal, sagittal suture or occipital bone. And frequently, sources of the bleeding were venous sinuses or fracture site. The patients who had vertex EDH were paraparetic soon after injury and the patients who had posterior fossa EDH were dangerous due to brain stem compression. We treated successfully the 13 patients who had vertex EDH(7 patients) and posterior fossa EDH(6 patients) by the method of one or two burr holes and urokinase irrigation. The authors represented this method may occasionally be preferable to craniotomy for these lesions. Advantages of the methods were 1) More simple, cosmatic procedure and no need of cranioplasty. 2) Reduced operation time and morbidity. 3) Enable to operate under local anesthesia. 4) Reduced rate of delayed intracranial hematoma due to acute decompression of epidural hematoma. 5) Reduced the date of admission. 6) Possibly, prevention of rebleeding and air embolism.