Traumatic posterior fossa extradural haematomas (PFEDH)

Area of Science:

• Neurosurgery
• Trauma Medicine
• Radiology

Background:

• Posterior fossa extradural haematomas (PFEDH) can cause rapid neurological decline and death due to brainstem compression.
• Prompt treatment of PFEDH is often associated with favorable outcomes.
• The diagnosis of PFEDH is challenging due to non-specific clinical signs and its rarity in head trauma.

Purpose of the Study:

• To identify clinical and radiological features indicative of posterior fossa extradural haematomas (PFEDH).
• To facilitate earlier diagnosis and intervention for patients with PFEDH.

Main Methods:

• Retrospective analysis of 13 surgically treated posterior fossa extradural haematomas (PFEDH).
• Review of patient case records, including mechanism of injury, clinical presentation, and CT scan findings.
• Analysis of outcomes based on Glasgow Coma Scale (GCS) scores.

Main Results:

• The majority of PFEDH cases (77%) presented within 24 hours of injury.
• Common injury mechanisms included falls, road traffic accidents, and assault.
• Key diagnostic indicators included occipital soft tissue injury (9 cases), skull fractures (8 cases), and diastasis of the lambdoid suture (2 cases).
• Aerocele was noted on CT scans in 4 cases.
• Patients admitted with a GCS score > 8 showed very good outcomes.

Conclusions:

• An early CT head scan is recommended for patients presenting with a combination of occipital soft tissue injury, drowsiness, occipital fracture, or lambdoid suture diastasis.
• These findings can aid in the prompt diagnosis of potentially life-threatening posterior fossa extradural haematomas (PFEDH).