Title: Traumatic Posterior Fossa Extradural Hematoma–Experience at a Tertiary Care Centre
Authors: Vidhya Narasimhan, K Deiveegan, R Mohan Kumar
DOI: https://dx.doi.org/10.18535/jmscr/v7i2.170
Abstract
Traumatic Posterior Fossa Extradural Hematoma (PFEDH) needs immediate and appropriate management because, the proximity to brain stem and the smaller posterior fossa volume can lead to rapid deterioration of the patient. This study was done to analyse the demographic profile, mode of injury, clinical features and management of PFEDH and the factors associated with outcome. 8512 patients admitted with head injury in 3 year period were studied prospectively. Of the 8512 patients, 702 (8.2%) had EDH. 45 patients (6.4% of EDH) had PFEDH. The Common presenting history were post traumatic loss of consciousness and vomiting. Occipital fracture was found in 82% and Supratentorial extension of PFEDH was found in 18% of cases. 60% of patients underwent surgical evacuation of PFEDH. 89% (40) patients had good outcome (GOS-5) and mortality rate was 8.8% (4). 98% of patients with GCS > 8 had good outcome compared to 25% in patients with GCS <= 8. Out of 4 patients who expired, 3(75%) had other associated severe intradural injuries. Road Traffic Accident (RTA) was the commonest mode of injury in adults and fall in children. RTA and train accidents were often associated with countercoup intradural hematomas. Volume of PFEDH was an important factor in deciding the line of management. Admission GCS score was the most important predictor of outcome. Children and elderly had good outcome. Associated intradural hematomas led to poorer outcome.
Keywords: Extradural hematoma, head injury.
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