Elsevier

Pediatric Neurology

Volume 6, Issue 2, March–April 1990, Pages 112-118
Pediatric Neurology

Case report
Nonsurgical treatment of posterior fossa epidural hematoma

https://doi.org/10.1016/0887-8994(90)90044-2Get rights and content

Abstract

The recommended treatment for posterior fossa epidural hematoma has been prompt surgical evacuation. We report 2 patients who were treated conservatively. Both patients were younger than 10 years of age and developed subacute symptoms and signs. Serial computed tomography demonstrated complete resolution of the hematomas and no development of hydrocephalus during nonsurgical treatment. They recovered well without any neurologic deficits. In order to evaluate an indicative factor for nonsurgical treatment in young children with posterior fossa epidural hematoma, we review both of our patients and 36 well-documented patients from the literature, all of whom were younger than 10 years of age. The results demonstrate that the development of hydrocephalus is a critical factor in clinical progression. Nonsurgical management can be applied in these circumstances until spontaneous resolution of the hematoma unless early signs of medullary compression appear acutely after head trauma or serial computed tomography demonstrates the development of hydrocephalus followed by medullary compression.

References (34)

  • N. Aoki

    Rapid resolution of acute epidural hematoma. Report of two cases

    J Neurosurg

    (1988)
  • R. Bullock et al.

    Nonoperative management of extradural hematoma

    Neurosurgery

    (1985)
  • K. Ericson et al.

    Computed tomography of epidural hematomas. Association with intracranial lesions and clinical correlation

    Acta Radiol [Diagn]

    (1981)
  • R. Illingworth et al.

    Conservative management of intracranial extradural haematoma presenting late

    J Neurol Neurosurg Psychiatry

    (1983)
  • T. Kuroiwa et al.

    Conservative treatment for the acute stage traumatic intracranial hematoma

    Neurol Med Chir

    (1985)
  • D. Pang et al.

    Nonsurgical management of extradural hematomas in children

    J Neurosurg

    (1983)
  • E. Pozzati et al.

    Spontaneous healing of extradural hematomas. Report of four cases

    Neurosurgery

    (1984)
  • E. Pozzati et al.

    Spontaneous healing of acute extradural hematomas. Study of twenty-two cases

    Neurosurgery

    (1986)
  • H. Tochio et al.

    Spontaneous resolution of chronic epidural hematomas. Report of three cases

    Neurosurgery

    (1984)
  • D. Weaver et al.

    Spontaneous resolution of epidural hematomas. Report of two cases

    J Neurosurg

    (1981)
  • H.R. Wharton

    Wounds of the venous sinuses of the brain. An analysis of seventy cases

    Ann Surg

    (1901)
  • E. Campbell et al.

    Extradural hematomas of the posterior fossa

    Ann Surg

    (1953)
  • R.S. Hooper

    Extradural haemorrhages of the posterior fossa

    Br J Surg

    (1954)
  • D. Parkinson et al.

    Double lucid interval in patients with extradural hematoma of the posterior fossa

    J Neurosurg

    (1971)
  • B. Borovich et al.

    Delayed onset of traumatic extradural hematoma

    J Neurosurg

    (1985)
  • H. Sakai et al.

    Serial changes in acute extradural hematoma size and associated changes in level of consciousness and intracranial pressure

    J Neurosurg

    (1988)
  • L.A. Cervantes

    Concurrent delayed temporal and posterior fossa epidural hematomas. Case report

    J Neurosurg

    (1983)
  • Cited by (0)

    View full text