Summary
A case of spontaneous posterior fossa subdural hematoma secondary to anticoagulation therapy with definitive diagnosis made by vertebral angiography is reported. Vertebral angiographic findings are illustrated and demonstrate primarily mass effect from posterior compartment of posterior fossa and avascular area. Carotid angiography did not show hydrocephalus. A review of the literature was made and this appears to be the first reported case in which a posterior fossa subdural hematoma has been diagnosed by vertebral angiography.
Résumé
On rapporte ici un cas d'un hématome sous-dural spontané de la fosse postérieure, secondaire à l'administration des anticoaglants, où un diagnostic définitif a été fait par l'angiographie vertébrale. Les résultats de l'angiographie vertébrale sont illustrés et démontrent dans le principe l'effet d'une masse du compartiment postérieur de la fosse postérieure et une zone avasculaire. L'angiographie carotidienne n'a pas montré d'hydrocéphalie. On a fait une revue de la littérature et, à la connaissance des auteurs, c'est le premier cas rapporté dans lequel un hématome sous-dural de la fosse postérieure a été diagnostiqué par l'angiographie vertébrale.
Zusammenfassung
Es wird ein Fall von spontanem subduralem Hämatom in einer Frau besprochen, die unter Antikoagulationbehandlung stand. Die Diagnose wurde durch eine Vertebralis-Arteriographie erstellt. Die wesentlichen Befunde waren eine avasculäre Schale und ein Masseneffekt in der hinteren Schädelgrube. Die Carotis-Angiographie zeigte keinen Hydrocephalus. Nach Durchsicht der einschlägigen Literatur scheint dies der erste Fall zu sein, in welchem ein subduraler Hämatom der hinteren Schädelgrube mit Hilfe der Vertebralis-Arteriographie diagnostiziert wurde.
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References
Vance, B. M.: Fractures of the skull. Complications and causes of death: A review of 512 necropsies and of 61 cases studied clinically. Arch. Surg. 14, 1023–1092 (1927)
Munroe, D.: The diagnosis and treatment of subdural hematomas. A report of sixty-two cases. New Engl. J. Med. 210, 1145–1160 (1934)
Coblentz, R. G.: Cerebellar subdural hematoma in infant 2 weeks old with secondary hydrocephalus. Operation with recovery. Surgery 8, 771–776 (1940)
Gross, S. W.: Posterior fossa hematomas. J. Mt. Sinai Hosp. 22, 286 (1955)
Ciembroniewicz, J. E.: Subdural hematoma of the posterior fossa. Review of the literature with addition of three cases. J. Neurosurg. 22, 465–473 (1965)
Dany, A., et al.: Hematome sous-dural aigu traumatique de la fosse posterieure chez un enfant de 17 mois. Neurochirurgie 12, 539–541 (1966)
Pitlyk, P. J., et al.: Subdural hematoma of the posterior fossa: Report of a case. Pediatrics 40, 436–439 (1967)
Zenteno-Alanis, G. H., et al.: Subdural hematoma of the posterior fossa as a complication of anticoagulant therapy. Neurology 18, 1133–1136 (1968)
Wright, J. R., et al.: Intracranial aneurysm as a cause of subdural hematoma of the posterior fossa. J. Neurosurg. 22, 86–89 (1968)
Weinman, D., Muttucumaru, B.: Traumatic haematoma of the posterior cranial fossa. Ceylon Med. J. 15, 25–30 (1970)
Capistrant, T., et al.: Posterior fossa subdural hematoma associated with anticoagulation therapy. J. Neurol. Neurosurg. Psychiat. 34, 82–85 (1971)
Jelicic, I., Stancic-Rokotov, F.: Chronic subdural hematoma of the posterior fossa. Med. Assn. of Crotis Med. J. 90, 44–48 (1968)
Reigh, E. E., Nelsen, M.: Posterior-fossa subdural hematoma with secondary hydrocephalus. Report of case and review of the literature. J. Neurosurg. 19, 346–348 (1962)
Wright, R. L.: Traumatic hematomas of the posterior cranial fossa. J. Neurosurg. 25, 402–409 (1966)
Martinez, J., Crutchfield, W. G.: Ventriculography in the localization of aberrant post-traumatic intracranial clots. Report of a case of acute subtentorial subdural hematoma. South. Surg. (American Surgeon) 15, 97–101 (1949)
Shealy, C. N.: Subdural hematoma in posterior fossa. Report of a case complicated by meningitis in a newborn infant. Ohio State Med. J. 62, 1172–1173 (1966)
Carter, L. P.: Posterior fossa subdural hematoma of the newborn. Case Report. J. Neurosurg. 34, 423–426 (1971)
Clitherow, N. R., et al.: Combined intracerebellar and posterior fossa subdural hematoma. Case Report. J. Neurosurg. 30, 744–746 (1969)
Arseni, C., Maretsis, M.: Traumatic cerebellar haematoma associated with posterior cerebral fossa subdural haematoma. Psychiat. Neurol. Neurochir. (Amst.) 75, 113–115 (1972)
Clark, E., Walton, J. N.: Subdural haematoma complicating intracranial aneurysm and angioma. Brain 76, 378–404 (1953)
Wright, R. L.: Unsuspected chronic subdural hematoma. A five year survey. V. A. Med. Monthly 83, 305–306 (1956)
Afra, D.: Neurochirurgische Eingriffe bei Verletzungen der hinteren Schädelgrube. Beitr. Neurochir. 8, 148–151 (1964)
Koch, R. L., Glickman, M. G.: The angiographic Diagnosis of extradural hematoma of the posterior fossa. Am. J. Roentgenol. 112, 289–295 (1971)
Newton, T. H.: Anterior and posterior meningeal branches of vertebral artery. Radiology 91, 271–279 (1968)
Todrow, S.: Angiographie des Confluens sinnum (Torcular Herophili) bei epiduralen Hämatomen der hinteren Schädelgrube. Radiologe 11, 410–411 (1971)
Achslogh, J.: Hematome sous-dural chronique de la fosse cerebrale posterieure. Acta. Neurol. (Belg.) 52, 790 (1952)
Horvath, L., Marinescu, V.: Chronic subdural hematoma of the posterior cranial fossa. Acta neurochirur. (Wien) 11, 579–582 (1964)
Ramirez-Lassepas, M.: Spontaneous (non-traumatic) subdural hematoma of the posterior cranial fossa in patients on anticoagulants. A Distinct Neurological Syndrome (in preparation)
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McClelland, R.R., Ramirez-Lassepas, M. Posterior fossa subdural hematoma demonstrated by vertebral angiography. Neuroradiology 10, 181–185 (1976). https://doi.org/10.1007/BF00329994
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DOI: https://doi.org/10.1007/BF00329994