Traumatic posterior fossa subdural hematomas

被引:12
作者
Takeuchi, Satoru [1 ]
Takasato, Yoshio [2 ]
Wada, Kojiro [1 ]
Nawashiro, Hiroshi [1 ]
Otani, Naoki [1 ]
Masaoka, Hiroyuki [2 ]
Hayakawa, Takanori [2 ]
机构
[1] Natl Def Med Coll, Dept Neurosurg, Tokorozawa, Saitama 3598513, Japan
[2] Natl Hosp Org, Disaster Med Ctr, Dept Neurosurg, Tokyo, Japan
关键词
Head injury; acute subdural hematoma; posterior fossa; EVACUATION;
D O I
10.1097/TA.0b013e31823c89b3
中图分类号
R4 [临床医学];
学科分类号
1002 ; 100602 ;
摘要
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. (J Trauma. 2012; 72: 480-486. Copyright (C) 2012 by Lippincott Williams & Wilkins)
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页码:480 / 486
页数:7
相关论文
共 20 条
[1]   Abnormal Coagulation Tests Are Associated With Progression of Traumatic Intracranial Hemorrhage [J].
Allard, Christopher B. ;
Scarpelini, Sandro ;
Rhind, Shawn G. ;
Baker, Andrew J. ;
Shek, Pang N. ;
Tien, Homer ;
Fernando, Michael ;
Tremblay, Lorraine ;
Morrison, Laurie J. ;
Pinto, Ruxandra ;
Rizoli, Sandro B. .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 2009, 67 (05) :959-967
[2]   CONSERVATIVE TREATMENT OF A TRAUMATIC SUBDURAL-HEMATOMA OF THE POSTERIOR-FOSSA IN A CHILD - CASE-REPORT [J].
ASHKENAZI, E ;
CARMON, M ;
PASTERNAK, D ;
ISRAEL, Z ;
BENI, L ;
POMERANZ, S .
JOURNAL OF TRAUMA-INJURY INFECTION AND CRITICAL CARE, 1994, 36 (03) :406-407
[3]  
Bor-Seng-Shu Edson, 2004, Neurosurg Focus, V16, pECP1
[4]   ACUTE TRAUMATIC POSTERIOR-FOSSA SUBDURAL HEMATOMAS [J].
BORZONE, M ;
RIVANO, C ;
ALTOMONTE, M ;
BALDINI, M .
ACTA NEUROCHIRURGICA, 1995, 135 (1-2) :32-37
[5]  
Bullock M Ross, 2006, Neurosurgery, V58, pS47
[6]   Traumatic acute subdural haematomas of the posterior fossa: clinicoradiological analysis of 24 patients [J].
d'Avella, D ;
Servadei, F ;
Scerrati, M ;
Tomei, G ;
Brambilla, G ;
Massaro, F ;
Stefini, R ;
Cristofori, L ;
Conti, A ;
Cardali, S ;
Tomasello, F .
ACTA NEUROCHIRURGICA, 2003, 145 (12) :1037-1044
[7]   Mutism after evacuation of acute subdural hematoma of the posterior fossa [J].
Fujisawa, H ;
Yonaha, H ;
Okumoto, K ;
Uehara, H ;
Ie, T ;
Nagata, Y ;
Suehiro, E ;
Suzuki, M .
CHILDS NERVOUS SYSTEM, 2005, 21 (03) :234-236
[8]   Traumatic Acute Subdural Hematoma Extending from the Posterior Cranial Fossa to the Cerebellopontine Angle [J].
Gulsen, Salih ;
Sonmez, Erkin ;
Yilmaz, Cem ;
Altinors, Nur .
JOURNAL OF KOREAN NEUROSURGICAL SOCIETY, 2009, 46 (03) :277-280
[9]  
Hamasaki T, 1987, No To Shinkei, V39, P1083
[10]   Successful treatment of traumatic acute posterior fossa subdural hematoma: Report of two cases [J].
Hecimovic, I ;
Blagus, G ;
Kristek, B ;
Rukovanjski, M ;
Vrankovic, D .
SURGICAL NEUROLOGY, 1999, 51 (03) :247-251