Surgical Experience of Acute Traumatic Posterior Fossa Subdural Hematoma : Study of 6 Cases and Review of the Literatures.

Park, Jong Tae; Kim, Dae Won

Original Article

Journal of Korean Neurosurgical Society 2006;40(6): 441-444.

Jong Tae Park, Dae Won Kim

Department of Neurosurgery, School of Medicine, Institute of Wonkwang Medical Science, Wonkwang University, Iksan, Korea. jtpark@wonkwang.ac.kr

ABSTRACT

OBJECTIVE
The goal of this study is to evaluate the clinical results in six patients who underwent surgical decompression for the acute subdural hematomas(ASDH) of posterior cranial fossa.
METHODS
Six patients (five males and one female) who had undergone surgery for ASDH of posterior cranial fossa between 2000 and 2005, were evaluated retrospectively with regard to clinicoradiological findings and surgical outcomes. The mean age was 45.8 years (range 9~67 years).
RESULTS
Preoperative computed tomography showed ASDH on cerebellar hemisphere in four patients and on midline in two. All patients had the associated lesions such as subarachnoid hemorrhage, epidural or subdural hematoma, intraventricular hemorrhage, contusion or pneumocephalus in supratentorial area. Fracture of occipital bone was noted in two patients. Of the four patients who had 13 to 15 of Glasgow coma scale score at the time of admission, three were deteriorated within 24 hours after trauma. Of these three patients, delayed subdural hematoma developed 1 hour after initial normal CT finding in one patient and increased in thickness in another one. Postoperative outcome showed good recovery in three patients and moderate disability in one. Two patients were expired.
CONCLUSION
This study supports that early diagnosis based on strict observation and prompt surgery in the patients with ASDH in posterior fossa will lead to the best results.

Key Words: Head injury; Subdural hematoma; Posterior fossa; Outcome