A Retrospective Assessment of Traumatic Posterior Fossa Extradural Hematoma: An Observationla Study

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Abstract (English)

Abstract
Aim: The aim of the present study was to assess the traumatic posterior fossa extradural hematoma in UP region.
Methods: The present study was conducted at Department of Neurosurgery, Kashi Neuron Multispeciality
Hospital ,Ramnagar ,Varanasi UP, India for one year . We found a total of 596 cases of EDHs, of which only 50
(8.38%) were located in the posterior fossa. The records were retrospectively analyzed for clinical presentation,
admission Glasgow Coma Scale (GCS), mode of injury, radiological findings, any other associated intracranial
traumatic lesion, type of intervention and postoperative outcome.
Results: The mean age of patients was 29.7 years (4–43 years). 20 (40%) of them were below 18 years. 14 (28%)
of them were females. Most common mode of injury was road traffic accident (n = 35, 70%), rest were either fall
from height (n =12, 24%) or assault (n = 3, 6%). Post-resuscitation admission GCS varied from GCS 15 in 31
(62%) cases, GCS 13–14 in 9 (18%), GCS 9–12 in 7 (14%), and GCS 3–8 in 3 (6%) cases. Two patients died.
Mean follow-up duration was 68.2 months. At 6 months follow-up, 44 (88%) patients had a good recovery (GOS
5) and at 12 months follow-up, 45 (90%) patients had GOS 5. In addition, patients with isolated PFEDH (n = 43)
had a much better outcome. 30 out of 43 were discharged with GCS 15. At 6 months and 12 months follow-up,
all 43 had good recovery (GOS 5).
Conclusion: PFEDH are rare. They may be rapidly fatal due to the expansion of hematoma and compromise of
the posterior cranial fossa space leading to brainstem compression, tonsillar herniation, and/or obstructive
hydrocephalus. Early diagnosis and emergent evacuation lead to good outcome. They are usually associated with
occipital bone fractures and may also have associated injuries in form of supratentorial or infratentorial subdural
hematoma, intraparenchymal hematoma or intraventricular hemorrhage.