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[Traumatism of the posterior fossa in children]
J E Guevara-Dondé1, R Ondarza-Rovira, M C Santillán-Gómez
1Departamento de Neurocirugía, Hospital de Traumatología Magdalena de las Salinas, México, D.F.
Insights
Pediatric posterior fossa hematomas, often resulting from head injuries, require prompt diagnosis and treatment. Surgical intervention offers a high success rate for these critical brain injuries in children.
Area of Science:
- Neurosurgery
- Pediatric Traumatology
- Neurology
Background:
- Posterior fossa hematomas in children are serious injuries.
- These hematomas can arise from head trauma and present with varied neurological states.
Purpose of the Study:
- To report on the characteristics and outcomes of pediatric posterior fossa hematomas.
- To evaluate treatment strategies and their effectiveness.
Main Methods:
- Retrospective case series of 15 children with posterior fossa hematomas.
- Analysis of hematoma types, clinical presentation, and treatment approaches (conservative vs. surgical).
Main Results:
- 11 epidural, 1 subdural, 2 cerebellar, and 1 brainstem hematoma identified.
- Surgical suboccipital intervention in 12 patients led to 11 successful recoveries.
- Conservative treatment in 3 patients resulted in sequelae for 2.
Conclusions:
- Posterior fossa hematomas in children necessitate a high index of suspicion with signs of head injury and posterior fossa lesions.
- Suboccipital surgery is an effective treatment for pediatric posterior fossa hematomas, yielding favorable outcomes.
Abstract:
Reported are 15 cases of children who suffered injuries to their posterior fossa and the subsequent formation of hematomas and their treatment by the physicians in the Neurosurgical Department of the Traumatology Hospital "Magdalena de las Salinas". Of the 15 cases, 11 had epidural hematomas (three of them with supratentorial extensions), one was subdural, two were cerebellar and another of the brainstem. Seven were considered acute, five were subacute and three were chronic. During their admittance to the hospital, five of the patients were in a state of coma, another five were sleepy or confused and the remaining five were conscious. Three of the patients were conservatively treated, two of which had sequelae or were moderately handicapped. Twelve of the patients were surgically intervened suboccipitally, eleven of which successfully recovered and one of which died. A history of brain injury, occipital fracture and signs of posterior fossa lesions lead to suspect the presence of posterior fossa hematoma.