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Spontaneous retroclival hematoma: a case series
Jared Narvid1, Matthew R Amans2, Daniel L Cooke2
1Divisions of 1 Neuroradiology and.
Journal of Neurosurgery
|August 8, 2015
Summary
Spontaneous retroclival hematoma (SRH), sometimes with intraventricular hemorrhage (IVH), is a rare condition. Despite its rarity, SRH often has a good prognosis, especially when imaging reveals no underlying cause.
Area of Science:
- Neurology
- Neurosurgery
- Radiology
Background:
- Retroclival hematomas (SRH) are uncommon, typically associated with trauma in children.
- Spontaneous retroclival hematomas (SRH) are rarely described, with no prior reports of concurrent intraventricular hemorrhage (IVH).
Observation:
- This study retrospectively analyzed four patients diagnosed with SRH over three years.
- All patients underwent thorough evaluation for coagulopathic and traumatic causes, with none identified.
- The observed SRH cases consistently crossed the basioccipital synchondrosis and were contained extradurally.
Findings:
- Spontaneous retroclival hematoma (SRH) is a rare intracranial hemorrhage subtype, often presenting with intraventricular hemorrhage (IVH).
- Magnetic resonance imaging (MRI) is crucial for identifying the compartmentalized nature of posterior fossa hemorrhages in SRH.
- The study identified four cases of SRH, all lacking identifiable traumatic or coagulopathic origins.
Implications:
- Spontaneous retroclival hematoma (SRH) requires careful diagnosis, often aided by MRI.
- Patients with SRH, particularly those without identifiable causative lesions on angiography, exhibit a favorable clinical outcome.
- This entity expands the spectrum of posterior fossa hemorrhages and highlights the importance of considering non-traumatic causes.
