Advertisement

Brain Edema XV pp 135-138 | Cite as

Traumatic Hematoma of the Posterior Fossa

  • Satoru TakeuchiEmail author
  • Kojiro Wada
  • Yoshio Takasato
  • Hiroyuki Masaoka
  • Takanori Hayakawa
  • Hiroshi Yatsushige
  • Keigo Shigeta
  • Toshiya Momose
  • Naoki Otani
  • Hiroshi Nawashiro
  • Katsuji Shima
Conference paper
Part of the Acta Neurochirurgica Supplement book series (NEUROCHIRURGICA, volume 118)

Abstract

Posterior fossa injury is rare, occurring in less than 3 % of head injuries. We retrospectively reviewed patients’ clinical and radiological findings, management, and outcomes. The aim of the present study was to investigate the features of posterior fossa hematoma, including posterior fossa epidural hematoma (EDH), posterior fossa subdural hematoma (SDH), and intracerebellar hematoma. From January 1995 to January 2009, 4,315 patients with head trauma were hospitalized at our institution. The ­present study focused on 41 patients (1.0 %) with traumatic hematomas of the posterior fossa. Eighteen patients had EDH, 10 patients had SDH, and 17 patients had intracerebellar hematomas. In each type of injury, occipital bone fractures were seen in many patients, and hematoma enlargement was often observed within a few days of the injury. In addition, a high frequency of associated lesions and a high poor outcome rate were features of intracerebellar hematomas and ­posterior fossa SDH. The present study suggests that repeat CT imaging and careful management are necessary until the lesion is stabilized, and patients showing lesions with mass effects should therefore be immediately treated with surgery.

Keywords

Head trauma Posterior fossa Epidural hematoma Subdural hematoma Intracerebellar hematoma 

Notes

Conflict of Interest

We declare that we have no conflict of interest.

References

  1. 1.
    Bor-Seng-Shu E, Aguiar PH, de Almeida Leme RJ, Mandel M, Andrade AF, Marino R Jr (2004) Epidural hematomas of the ­posterior cranial fossa. Neurosurg Focus 16:ECP1PubMedCrossRefGoogle Scholar
  2. 2.
    Borzone M, Rivano C, Altomonte M, Baldini M (1995) Acute traumatic posterior fossa subdural haematomas. Acta Neurochir (Wien) 135:32–37CrossRefGoogle Scholar
  3. 3.
    Bullock MR, Chesnut R, Ghajar J, Gordon D, Hartl R, Newell DW, Servadei F, Walters BC, Wilberger J, Surgical Management of Traumatic Brain Injury Author Group (2006) Surgical management of posterior fossa mass lesions. Surgical management of posterior fossa mass lesions. Neurosurgery 58:S47–S55PubMedGoogle Scholar
  4. 4.
    d’Avella D, Servadei F, Scerrati M, Tomei G, Brambilla G, Angileri FF, Massaro F, Cristofori L, Tartara F, Pozzati E, Delfini R, Tomasello F (2002) Traumatic intracerebellar hemorrhage: clinicoradiological analysis of 81 patients. Neurosurgery 50:16–25PubMedCrossRefGoogle Scholar
  5. 5.
    d’Avella D, Servadei F, Scerrati M, Tomei G, Brambilla G, Massaro F, Stefini R, Cristofori L, Conti A, Cardali S, Tomasello F (2003) Traumatic acute subdural haematomas of the posterior fossa: clinicoradiological analysis of 24 patients. Acta Neurochir (Wien) 145:1037–1044CrossRefGoogle Scholar
  6. 6.
    Hayashi T, Kameyama M, Imaizumi S, Kamii H, Onuma T (2007) Acute epidural hematoma of the posterior fossa – cases of acute clinical deterioration. Am J Emerg Med 25:989–995PubMedCrossRefGoogle Scholar
  7. 7.
    Jang JW, Lee JK, Seo BR, Kim SH (2011) Traumatic epidural haematoma of the posterior cranial fossa. Br J Neurosurg 25:55–61PubMedCrossRefGoogle Scholar
  8. 8.
    Karasawa H, Furuya H, Naito H, Sugiyama K, Ueno J, Kin H (1997) Acute hydrocephalus in posterior fossa injury. J Neurosurg 86:629–632PubMedCrossRefGoogle Scholar
  9. 9.
    Karasu A, Sabanci PA, Izgi N, Imer M, Sencer A, Cansever T, Canbolat A (2008) Traumatic epidural hematomas of the posterior cranial fossa. Surg Neurol 69:247–251PubMedCrossRefGoogle Scholar
  10. 10.
    Malik NK, Makhdoomi R, Indira B, Shankar S, Sastry K (2007) Posterior fossa extradural hematoma: our experience and review of the literature. Surg Neurol 68:155–158PubMedCrossRefGoogle Scholar
  11. 11.
    Otsuka S, Nakatsu S, Matsumoto S, Sato S, Motozaki T, Ban S, Yamamoto T (1990) Study on cases with posterior fossa epidural hematoma–clinical features and indications for operation. Neurol Med Chir (Tokyo) 30:24–28CrossRefGoogle Scholar
  12. 12.
    St John JN, French BN (1986) Traumatic hematomas of the posterior fossa. A clinicopathological spectrum. Surg Neurol 25:457–466PubMedCrossRefGoogle Scholar
  13. 13.
    Takeuchi S, Takasato Y, Masaoka H, Hayakawa T (2011) Traumatic intra-cerebellar haematoma: study of 17 cases. Br J Neurosurg 25:62–67PubMedCrossRefGoogle Scholar

Copyright information

© Springer-Verlag Wien 2013

Authors and Affiliations

  • Satoru Takeuchi
    • 1
    Email author
  • Kojiro Wada
    • 1
  • Yoshio Takasato
    • 2
  • Hiroyuki Masaoka
    • 2
  • Takanori Hayakawa
    • 2
  • Hiroshi Yatsushige
    • 2
  • Keigo Shigeta
    • 2
  • Toshiya Momose
    • 2
  • Naoki Otani
    • 1
  • Hiroshi Nawashiro
    • 1
  • Katsuji Shima
    • 1
  1. 1.Department of NeurosurgeryNational Defense Medical CollegeTokorozawa, SaitamaJapan
  2. 2.Department of NeurosurgeryNational Hospital Organization Disaster Medical CenterTachikawa, TokyoJapan

Personalised recommendations