Posterior fossa epidural hematoma: A 6-year management experience

Through this study, we sought to evaluate the management of posterior fossa extradural hematoma (PFEDH).

An observational study was conducted at the Neurosurgery Department of Lady Reading Hospital in Peshawar from January 2015 to December 2020. All patients who had a traumatic acute extradural hematoma (EDH) of the posterior fossa were included, irrespective of age and gender. The clinical predictors and outcomes were assessed, including the CT-scan findings and Glasgow Coma Scale (GCS) score.

A total of 104 cases with posterior fossa extradural hematoma were identified from 1252 extradural hematoma patients admitted during the study period. The mean age of the enrolled patients was 18.17 ± 14.31 years. Most of the patients were male (65.39%) and belonged to the pediatric age group, i.e., < 15 years (60.6%). CT scan brain was done in all the cases for diagnosis. In 68.3% of cases, an associated occipital bone fracture was observed. Surgery was done in almost 71.2% of cases, and most of the patients experienced good recovery after surgery, as indicated by the GOS score. Linear regression model revealed that treatment (β=-0.20, p=0.038), time duration between surgery and trauma (β=0.43, p=0.000) and GCS category (β=-0.47, p=0.000) were significantly associated with PFEDH outcomes.

In conclusion, PFEDH was frequent among males and the pediatric age group. Serial CT brain is highly recommended in all suspected cases for early diagnosis.