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[Chronic subdural hematoma of the posterior cranial fossa]

Insights

A rare, large chronic subdural hematoma in the posterior cranial fossa was successfully removed after a long illness, restoring the patient's working capacity. This case highlights diagnostic challenges and favorable outcomes in traumatic posterior fossa pathology.

Area of Science:

  • Neurology
  • Neurosurgery
  • Traumatology

Background:

  • Chronic subdural hematoma (CSH) is a rare condition, particularly in the posterior cranial fossa.
  • Long-standing CSH can present with complex and atypical symptoms, posing diagnostic challenges.
  • Childhood trauma can be a precursor to delayed CSH development.

Observation:

  • A 41-year-old patient presented with hypertensive syndrome, truncal and cerebellar symptoms, and suboccipital pain.
  • Computed tomography revealed a large (48 x 78 x 37 mm) posterior fossa mass extending from the tentorium cerebelli to the foramen magnum and clivus.
  • Surgical exploration identified a chronic subdural hematoma of the posterior cranial fossa.

Findings:

  • Complete surgical removal of the chronic subdural hematoma was achieved.
  • The total volume of removed hematoma (liquid and dense fractions) was 100 ml.
  • The patient experienced a full recovery of working capacity postoperatively.

Implications:

  • This case underscores the importance of considering CSH in the differential diagnosis of posterior fossa masses, even with a remote trauma history.
  • Large CSHs in this location, despite diagnostic difficulties, can be treated effectively with surgical intervention.
  • Favorable surgical outcomes are achievable, leading to significant patient recovery and restoration of function.

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