Acta Neurochirurgica

, Volume 126, Issue 2–4, pp 124–127 | Cite as

The CT criteria for conservative treatment — but under close clinical observation — of posterior fossa epidural haematomas

  • Ch. -W. Wong
Clinical Articles


In order to assess whether the indications for conservative treatment of supratentorial epidural haematomas are applicable also to posterior fossa epidural haematomas (PFEDH), the author reviewed the records of 25 patients. With a PFEDH volume of no more than 10 ml, a thickness of no more than 15 mm, a midline shift of no more than 5 mm, and in the absence of a significant intracranial haematoma elsewhere on computed tomography (CT) scans, the patients undergoing conservative treatment achieved the same excellent outcome as those undergoing early surgery. These CT criteria for conservative treatment of PFEDHs are similar to those of supratentorial epidural haematomas except the volume factor, namely, 10 ml in the former against 30 ml in the latter. That means a PFEDH of 10 ml or larger in the small posterior fossa may produce the same degree of midline shift and compression, and be as dangerous as an epidural haematoma of 30 ml or larger in the more capacious supratentorial compartment. But also for epidural haematomas of the posterior fossa, which initially are smaller than 10 ml, the general rule remains valid that they should be under close clinical supervision


Head injury epidural haematoma posterior fossa conservative treatment 


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Copyright information

© Springer-Verlag 1994

Authors and Affiliations

  • Ch. -W. Wong
    • 1
  1. 1.Division of Neurosurgery, Department of SurgeryChang Gung Memorial Hospital, Chang Gung Medical CollegeTaipeiTaiwan, Republic of China

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