Posterior fossa hemorrhages in the newborn

Of 700 neonates examined by computed tomography (CT) in a 4 years period, 17 were found to have a posterior fossa hemorrhage. Eleven were born at term, and six were premature. Delivery was traumatic in 12 babies. The hematoma was in the subdural space in nine and within the cerebellum in eight. The CT diagnosis of extravasated blood in the posterior fossa is easy both in full-term neonates and prematures. The localization of the hematoma, however, may be difficult. While in the full-term neonates differentiation between subdural and intracerebellar location is relatively easy, in the premature the cerebellar hematoma frequently has a crescentic shape that resembles a subdural collection. Four patients with a subdural hematoma and four with a cerebellar hematoma were operated on. The general prognosis is poor: seven patients died; of the survivors, only three are normal at follow-up.