Document Detail


Traumatic posterior fossa subdural hematomas.
MedLine Citation:
PMID:  22327987     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
BACKGROUND: Traumatic hematomas in the posterior fossa are rare, especially traumatic posterior fossa subdural hematomas (SDHs), which account for <1% of head injured patients. The aim of this study was to investigate the features of traumatic posterior fossa SDHs.
METHODS: We retrospectively reviewed clinical and radiologic findings, management, and outcomes of patients with traumatic posterior fossa SDH.
RESULTS: Ten patients with traumatic posterior fossa SDHs were admitted to our hospital. There were seven males and three females, with an age range of 3 years to 97 years (mean, 57.5 years). Coagulopathies were observed in five patients. The causes of injury were motor vehicle crash in three patients, falls in six patients, and being hit by an iron plate in one patient. The mean admission Glasgow Coma Scale score was 8.3. Skull fractures were revealed in six patients. Hematoma sizes ranged from 5 mm to 20 mm (mean, 7.7 mm). Two patients presented with isolated posterior fossa SDHs, and eight patients presented with associated intracranial lesions. Only one patient was treated surgically for posterior fossa SDHs associated with intracerebellar hematomas. The poor outcome rate was 90% and the mortality was 50%.
CONCLUSIONS: A review of the literature revealed the following characteristics of posterior fossa SDHs: (1) a relatively high frequency of occipital impacts and fractures, (2) a low Glasgow Coma Scale score, (3) a high frequency of associated intracranial lesions, especially supratentorial lesions and intracerebellar hematomas, (4) a potential for lesion evolution, especially within 2 days, and (5) a high poor outcome rate and mortality.
LEVEL OF EVIDENCE: IV.
Authors:
Satoru Takeuchi; Yoshio Takasato; Kojiro Wada; Hiroshi Nawashiro; Naoki Otani; Hiroyuki Masaoka; Takanori Hayakawa
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Publication Detail:
Type:  Journal Article    
Journal Detail:
Title:  The journal of trauma and acute care surgery     Volume:  72     ISSN:  2163-0763     ISO Abbreviation:  J Trauma Acute Care Surg     Publication Date:  2012 Feb 
Date Detail:
Created Date:  2012-02-13     Completed Date:  2012-05-04     Revised Date:  2013-09-25    
Medline Journal Info:
Nlm Unique ID:  101570622     Medline TA:  J Trauma Acute Care Surg     Country:  United States    
Other Details:
Languages:  eng     Pagination:  480-6     Citation Subset:  AIM; IM    
Affiliation:
Department of Neurosurgery, National Defense Medical College, 3-2 Namiki, Tokorozawa, Saitama, Japan. s.takeuchi@room.ocn.ne.jp
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Cranial Fossa, Posterior / injuries*
Female
Glasgow Coma Scale
Hematoma, Subdural / etiology*,  physiopathology,  radiography,  therapy*
Humans
Male
Middle Aged
Retrospective Studies
Tomography, X-Ray Computed
Treatment Outcome

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