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Traumatic acute subdural hematoma localized on the superior surface of the tentorium cerebelli--two case reports
K Matsumoto1, T Houri, T Yamaki
1Department of Neurosurgery, Kyoto Prefectural University of Medicine.
Insights
Unusual traumatic acute subdural hematomas occurred on the tentorium cerebelli in two patients after head injuries. Variant bridging vein injury is a potential cause of these rare tentorial subdural hematomas.
Area of Science:
- Neurology
- Radiology
- Trauma Surgery
Background:
- Traumatic acute subdural hematoma (tASH) is a severe brain injury typically found along the cerebral convexities.
- Hematomas located on the tentorium cerebelli are rare, posing diagnostic and therapeutic challenges.
Observation:
- Two patients, an 8-year-old boy and a 62-year-old female, presented with acute subdural hematomas specifically on the superior surface of the tentorium cerebelli following distinct head trauma.
- The boy sustained his injury from a fall downstairs, while the female experienced hers in an automobile accident.
Findings:
- Magnetic resonance imaging (MRI) was crucial in precisely identifying the tentorial location of the hematomas.
- MRI also confirmed the absence of significant brain parenchymal contusion in both cases.
- The findings suggest that injury to a variant bridging vein is the likely cause of these tentorial subdural hematomas.
Implications:
- This case series highlights the importance of considering tentorial subdural hematomas in the differential diagnosis of traumatic brain injury, especially when imaging reveals unusual locations.
- Recognizing the potential role of variant bridging vein injury can aid in understanding the pathophysiology and improving diagnostic accuracy for these rare injuries.
- Advanced neuroimaging techniques like MRI are essential for accurate localization and assessment of associated brain damage in tentorial subdural hematomas.
Abstract:
An 8-year-old boy, who fell downstairs and struck his head, and a 62-year-old female, who hit her head in the automobile accident, presented with unusual traumatic acute subdural hematoma localized on the superior surface of the tentorium cerebelli. Magnetic resonance imaging was useful for determination of the anatomical location of the hematoma, and confirmation of absence of significant parenchymal contusion. Injury of the variant bridging vein possibly caused subdural hematoma over the tentorium.