Spontaneous posterior fossa extradural hematoma--a rare complication following cardiac surgery

Posterior fossa extradural hematoma (PFEDH) is an infrequent condition. Though numerous neuropathological sequelae of cardiopulmonary bypass have been described, to the best of the authors' knowledge, PFEDH after cardiac surgery has not been reported in the English literature. We report a 4-year-old boy with tricuspid atresia, who underwent cardiac surgery under cardiopulmonary bypass. On the 2nd postoperative day, his neurological condition deteriorated, and a CT scan of the head revealed a large PFEDH with mass effect and hydrocephalus. He underwent a midline suboccipital craniectomy and evacuation of PFEDH. There was diffuse bleeding from the dura; however, no specific site of bleeding was identified. The child started following commands on the 1st postoperative day, had an uneventful recovery and was discharged on the 10th postoperative day. On follow-up, 1 year after the surgery, he was doing well.