Surgical Outcome of Traumatic Posterior Fossa Extradural Hematoma in Paediatric Population: Our Experience at UCHS, The Children’s Hospital, Lahore

Authors

  • Jamal Nasir The Childerns Hospital Lahore
  • Faiq Sheikh PINS
  • Saba Benish The Childerns Hospital Lahore
  • Laeeq ur Rehman
  • Ali Asad Services Hospital Lahore
  • Lubna Ejaz The Childerns Hospital Lahore

DOI:

https://doi.org/10.36552/pjns.v26i2.677

Keywords:

Glasgow Coma Scale (GCS),, Extradural Hematoma, Posterior Cranial Fossa, Occipital Fracture

Abstract

Objective:  Most common location for Extradural hematoma (EDH) is within the supratentorial region. The incidence of Posterior fossa extradural hematoma (PFEDH) is1.2% to 12.9% of all EDH. The purpose of this study is to evaluate the management, clinical outcomes, and epidemiological features of posterior fossa EDH.

Materials and Methods:  A cross-sectional study was conducted at the department of pediatric neurosurgery Children Hospital and the University of child health sciences, Lahore from September 2021 to December 2021. Thirty patients presented with posterior fossa extradural hematoma in the pediatric age group were included. A plain CT scan Brain with the bone window was done for initial diagnosis to assess any injury in the posterior fossa including volume of hematoma and any associated fracture. Glasgow Coma Scale (GCS) was used to evaluate the outcome.

Results:  Twenty-five patients were surgically treated, and five patients were managed conservatively. There was no mortality observed and the overall results were good in all the patients.

Conclusion:  As compared to supratentorial extradural hematoma the Posterior fossa epidural hematoma is uncommon. For all suspected cases early and serial CT scans must be carried out. There was an excellent prognosis in pediatric patients who underwent surgical management.

References

Rosenthal AA, Solomon RJ, Eyerly-Webb SA, Sanchez R, Lee SK, Kiffin C, Davare DL, Hranjec T, Carrillo EH. Traumatic epidural hematoma: patient characteristics and management. The American Surgeon. 2017 Nov;83(11):438-40.

Tamburrelli FC, Meluzio MC, Masci G, Perna A, Burrofato A, Proietti L. Etiopathogenesis of traumatic spinal epidural hematoma. Neurospine. 2018 Mar;15(1):101.

Pryse-Phillips W. Companion to clinical neurology. Oxford University Press; 2009 Jun 3.

Takeuchi S, Wada K, Takasato Y, Masaoka H, Hayakawa T, Yatsushige H, Shigeta K, Momose T, Otani N, Nawashiro H, Shima K. Traumatic hematoma of the posterior fossa. InBrain Edema XV 2013 (pp. 135-138). Springer, Vienna.

Huisman TA, Tschirch FT. Epidural hematoma in children: do cranial sutures act as a barrier?. Journal of Neuroradiology. 2009 May 1;36(2):93-7.

Ciurea AV, Kapsalaki EZ, Coman TC, Roberts JL, Robinson J3, Tascu A, Brehar F, Fountas KN. Supratentorial epidural hematoma of traumatic etiology in infants. Child's nervous system. 2007 Mar;23(3):335-41.

Agrawal A, Timothy J et-al Bradycardia in neurosurgery clinNeurol Neurosurg.2008 Apr;110(4):321-7.

HismanTA,TscirchFT.Epiduralhaematoma in children:do cranial sutures act as a barrier?.Neuroradial.2009;36(2);93-7.

Bedry T, Tadele H. Pattern and outcome of pediatric traumatic brain injury at hawassa university comprehensive specialized hospital, southern Ethiopia: observational cross-sectional study. Emergency medicine international. 2020 Jan 29;2020.

Khairat A, Waseem M. Epidural hematoma. InStatPearls [Internet] 2021 Aug 2. StatPearls Publishing.

Al-Nakshabandi NA. The swirl sign. Radiology. 2001 Feb;218(2):433-.

Shahlaie K, Zweienenberg-Lee M, MuizelaarJP. Climical pathophysiology of traumatic brain injury.In:WinnHR,ed.Youmans and Winn Neurological Surgery.7thed.Philadelphia,PA: Elsevier; 2017:chap 346.

Berker M, Cataltepe O, Özcan OE. Traumatic epidural haematoma of the posterior fossa in childhood: 16 new cases and a review of the literature. British journal of neurosurgery. 2003 Jan 1;17(3):226-9.

Ciurea AV, Nuteanu L, Simionescu N, Georgescu S. Posterior fossa extradural hematomas in children: report of nine cases. Child's Nervous System. 1993 Jul;9(4):224-8.

Ersahin Y, Mutluer S : Posterior fossa extradural hematomas in children. Pediatr Neurosurg 19 : 31-33, 1993

Gupta PK, Mahapatra AK, Lad SD : Posterior fossa extradural hematoma. Indian J Pediatr 69 : 489-494, 2002

Prasad GL, Gupta DK, Sharma BS, Mahapatra AK : Traumatic pediatric posterior fossa extradural hematomas: a tertiary-care trauma center experience from India. Pediatr Neurosurg 50 : 250-256, 2015

Sencer A, Aras Y, AkcAkAyA MO, Goker B, K?r?s T, Canbolat AT. Posterior fossa epidural hematomas in children: clinical experience with 40 cases. Journal of Neurosurgery: Pediatrics. 2012 Feb 1;9(2):139-43.

Malik NK, Makhdoomi R, Indira B, Shankar S, Sastry K. Posterior fossa extradural hematoma: our experience and review of the literature. Surgical neurology. 2007 Aug 1;68(2):155-8.

Kumar JS, Kumar GT, Gaurav J, Kumar LV, Patel P. Traumatic isolated intracerebellar haematoma without any supratentorial lesion. A rare entity. Management strategy. Romanian Neurosurgery. 2020 Dec 1;34(4).

Chaoguo Y, Xiu L, Liuxun H, Hansong S, Nu Z. Traumatic posterior fossa epidural hematomas in children: experience with 48 cases and a review of the literature. Journal of Korean Neurosurgical Society. 2019 Mar;62(2):225

Downloads

Published

2022-07-17