Traumatic posterior fossa extradural hematoma: observations on a series of 17 cases and a review of the literature

ABSTRACT

Seventeen patients with posterior fossa extradural hematoma were managed at Zagazig University Hospital between January 1995 and December 2000, accounted 2.9% of all cranial epidural hematomas. The mean age was 23.1 years, with 7 children and 10 adults. Impaired conscious level was noted in 14 patients [82.4%]. None of the patients had localizing cerebellar signs. Occipital soft tissue injury in 14 patients [82.4%]. Fall from height was the causative trauma in 7 patients [41.0%]. Delayed appearance of the hematoma was noted in only one patient [5.9%]. Occipital fissure fracture was found in 15 patients [88.2%], supratentorial extension in 9 patients [52.9%,], hydrocephalus in 6 patients [35.3%] and supratentorial associated injuries in 6 patients [35.3%]. Surgery was performed on 14 patients [82.4%]. Good recovery was noted in 12 patients [70.6%], severe disability in one patient [5.9%,] and death in 4 patients [23.5%]. Patients consciousness, brain stem dysfunction, obliteration of the 4[th] ventricle and quadrigeminal cistern, associated cerebellar and multiple cerebral contusions were factors significantly influenced the outcome [P <0.05]