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Published on: October 15, 2021
Retroclival epidural hematomas: a clinical series
R Shane Tubbs1, Christoph J Griessenauer, Todd Hankinson
1Pediatric Neurosurgery, Children's Hospital, Birmingham, Alabama, USA.
Neurosurgery
|July 21, 2010
Summary
Retroclival epidural hematomas (REDHs) are rare but may be underdiagnosed. This study found REDHs are often linked to motor vehicle trauma and atlanto-occipital dislocation, with many patients experiencing minimal long-term effects.
Area of Science:
- Pediatric Neurosurgery
- Trauma Surgery
- Neuroradiology
Background:
- Retroclival epidural hematomas (REDHs) are rare, with limited case reports available.
- Understanding the pathology and outcomes of REDH is crucial for effective management.
Purpose of the Study:
- To investigate the characteristics and outcomes of pediatric patients with REDH.
- To identify potential associations between REDH and other injuries.
Main Methods:
- Prospective data collection for pediatric patients diagnosed with REDH from July 2006 to June 2009.
- Inclusion of data on injury mechanism, Glasgow Coma Scale (GCS) score, neurological examination, treatment, and outcomes.
- Use of Magnetic Resonance Imaging (MRI) to measure hematoma dimensions.
Main Results:
- Eight pediatric patients diagnosed with REDH, all secondary to motor vehicle trauma.
- Mean patient age was 12 years; mean REDH height was 4.0 cm and thickness 1.0 cm.
- Mean GCS score was 8; no correlation found between hematoma size and symptoms. Two patients died, two had atlanto-occipital dislocation requiring surgery. No surgical evacuation of REDH was performed.
Conclusions:
- This series of 8 pediatric patients represents the largest reported cohort of REDH.
- REDH may be underdiagnosed, and atlanto-occipital dislocation should be considered in all cases.
- Many patients with REDH may experience minimal long-term neurological deficits.
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