Traumatic epidural hematoma of the posterior fossa is relatively rare and represents 4% to 12.9% of the entire group of extradural hematoma patients. The present study included eleven patients with traumatic epidural hematoma of the posterior fossa representing 4% of all 268 patients with traumatic epidural hematomas treated surgically during the period between 1995 and 2000. Male to female ratio was 4.5.: 1. Age of the patients ranged between 4 years and 60 years with an average age of 23 years. 63.6% of the patients fell in the age group 10 to 20 years. The clinical course was acute in 72.7%, subacute in 18.2% and chronic in 9% of the patients. Lucid interval was recorded in 45.5%.of the patients. Local evidence of occipital trauma was the commonest sign (81.8%). 63.6% of patients with Glasgow coma scale (GCS) of 9-12 and the remaining 36.4% of patients presented with GCS of 5-8. er scan made the diagnosis in all patients. Occipital fractures were detected in 72.7%, associated intracranial injuries were noted in 45.5% and compression of the 4th ventricle with hydrocephalus were detected in 18.2% of the patients. All patients were treated surgically. Mortality rate was 9%.The final outcome was found to be influenced by postresuscitation GCS, as all patients withGCS of 9-12 had good recovery, while 25% of patients with
GCS of 5-8 had good recovery. Clinical awareness, early diagnosis and prompt evacuation of the hematoma can avert a disastrous outcome. |
