Extradural hematoma of posterior cranial fossa that related to closed head injuries was rare and difficult diagnosis. The study involved 45 patients. 40/45 patients had signs of hematoma in occipital region, 34/45 patients had headache, 28/45 patients had vomit, 22/45 had dizziness, 30/45 patients had sleepy. 23 patients received X-ray imaging, in which, 11 patients showed the rupture of occipital bone. On CT images, rate of partial ventricular collapse and displacement was 95.6%. 28/45 patients with posterior fossa extradural hematoma had conscious duration. And in 18 patients this duration longed for more than 1 days. Perception worsened rapidly is a common sign of posterior fossa extradural hematoma, especially in acute hematoma. Mortality of posterior fossa extradural hematoma was 20%. Rate of patient without post-operative complication was 71.1%. Rate of patient with post-operative complication was 8.9%.
Craniocerebral Trauma ; Hematoma, Epidural, Cranial ; Head Injuries, Closed

OBJECTIVE: The aim of this preliminary collaborative study was to assess the clinical characteristics, management, and outcome of epidural hematoma (EDH) based on the data collected and registered in the Korean Trauma Data Bank System (KTDBS). METHODS: Of 2,698 patients registered in the KTDBS between September 2010 and March 2014, 285 patients with EDH were analyzed. Twenty-three trauma centers participated in the study voluntarily to collect data. We subcategorized the patients into two groups with good and poor outcomes. Various clinical characteristics and the time intervals with regard to treatment course were investigated to determine the relationship between these parameters and the functional outcome. RESULTS: Of multiple parameters for this analysis, older age (p=0.0003), higher degree of brain injury (p<0.0001), cases of surgical EDH (p<0.0001), time interval from trauma to hospital before 6 hours, and the decreasing pattern of Glasgow Coma Scale (GCS) between and initial and final GCS were strongly associated with poor outcome. Use of prophylactic anticonvulsant did not affect the functional outcome. There was an interesting difference in the use of mannitol in treating EDH between the urban and rural regions (p<0.0001). CONCLUSION: This is the first multi-center analysis of etiology of injury, pre-hospital care, treatment, and functional outcome of EDH in Korea. The degree of brain injury and the GCS difference were notable factors that were significant in determining the functional outcome of EDH.
Brain Injuries ; Glasgow Coma Scale ; Hematoma* ; Hematoma, Epidural, Cranial ; Humans ; Korea* ; Mannitol ; Republic of Korea ; Trauma Centers

Epidural hematomas are usually traumatic in origin. Non-traumatic spontaneous epidural hematoma is rare and its incidence is not known. It can occur in the presence of coagulopathy and hypotension. We report a case of spontaneous intracranial epidural hematoma following the aortic valve replacement, possibly arising from excessive anticoagulation and hypotension during ventricular fibrillation.
Aortic Valve ; Hematoma ; Hematoma, Epidural, Cranial ; Hypotension ; Incidence ; Thoracic Surgery ; Ventricular Fibrillation

We report a unique case of a neonate with an epidural hematoma induced by vacuum extraction. The epidural hematoma, communicating with a cephalhematoma through a linear skull fracture, disappeared after ultrasound-guided needle aspiration. The patient quickly recovered and one month later computed tomography revealed a complete resolution of the epidural hematoma.
Hematoma ; Hematoma, Epidural, Cranial* ; Humans ; Infant, Newborn* ; Needles* ; Skull Fractures ; Vacuum

Posterior fossa epidural hematoma (EDH) is uncommon, but the related clinical deterioration can occur suddenly. Accompanying venous sinus injury and lacerations are associated with 40% to 80% mortality. The authors present one clinical case of a patient with posterior fossa EDH from transverse sinus bleeding. A 57-year-old male was injured after falling while working. He was taken to the hospital, where computed tomography scans of his brain revealed a right posterior temporal and cerebellar EDH with a right temporo-occipital fracture. He underwent a right parieto-occipital craniotomy, incorporating the fracture line. Longitudinal laceration of the right transverse sinus extending to the sigmoid sinus with profuse bleeding was identified. Four gauzes were inserted in the epidural space for tamponade of the injured sinus. Conventional angiography and coil embolization for the injured sinus were immediately performed. Subsequently, the patient was transferred to the operating room, wherein staff members removed the gauzes and remnant hematoma. Based on this experience, the authors recommend that for posterior fossa EDH from transverse sinus bleeding, bleeding control should be performed by gauze packing and endovascular treatment.
Accidental Falls ; Angiography ; Brain ; Colon, Sigmoid ; Cranial Fossa, Posterior ; Craniotomy ; Embolization, Therapeutic ; Epidural Space ; Hematoma ; Hematoma, Epidural, Cranial ; Hemorrhage* ; Humans ; Lacerations ; Male ; Middle Aged ; Mortality ; Operating Rooms

OBJECTIVETo explore the therapeutic methods, surgical indications and clinical practice of minimally invasive surgery on traumatic epidural hematoma (EDH).

METHODSRetrospective study was made on 135 patients with traumatic EDH admitted into our hospital from June 2002 to August 2005. Sixty-five patients were treated with mini-invasive negative pressure drainage (treatment group), 70 patients with comparable condition used traditional craniotomy (control group). The mean time of operation, average days in hospital, expenditure and prognosis of two groups were recorded and analyzed.

RESULTSThere was no significant difference in therapeutic efficacy between two groups. Patients in treatment group had a shorter hospital stay and less expenditure than those in control group.

CONCLUSIONMini-invasive negative pressure drainage is simple, effective, economical and applicable to some traumatic EDH patients.

Spontaneous intracranial hypotension (SIH) is a well-known disorder improving with conservative treatment or epidural blood patch in the majority of cases. However, SIH may develop neurological complications such as cranial nerve palsy, subdural hematoma, and altered consciousness. Subdural hematoma in SIH is usually found during intracranial hypotension state and delayed subdural hematoma is rarely reported. We report a case of delayed subdural hematoma and oculomotor nerve palsy after improving spontaneous intracranial hypotension.
Blood Patch, Epidural ; Consciousness ; Cranial Nerve Diseases ; Hematoma, Subdural ; Intracranial Hypotension ; Oculomotor Nerve ; Oculomotor Nerve Diseases

We report a case of spontaneous intracranial epidural hematoma following the intraoperative course of a patient who had undergone surgical removal of a thoracolumbar schwannoma in olivo-ponto-cerebellar atrophy. To our knowledge there is no reported case in which the thoracolumbar schwannoma removal was followed by such a complication. Mechanical events leading to this complication are unclear. Abnormal results of a neurological examination in the early postoperative period should suggest this possibility.
Hematoma, Epidural, Cranial* ; Humans ; Neurilemmoma* ; Neurologic Examination ; Olivopontocerebellar Atrophies ; Postoperative Period

Child ; Cochlear Implantation ; adverse effects ; Hematoma, Epidural, Cranial ; etiology ; Humans ; Male

Large amount of epidural hematoma usually requires surgical intervention. When the amount of epidural hematoma is increasing gradually, causing neurological symptoms, an early emergent surgery may be the only way to prevent lethal outcome. Among many factors associated with the prognosis, age, amount of hematoma, patient's consciousness at the time of admission, and other accompanying injuries are known to be important factors. However, in some cases, symptoms may be exacerbated due to causes other than the increase in epidural hematoma, such as cerebral infarction. In particular, calcification of the internal carotid artery is known to be an important factor that causes acute cerebral infarction before and after surgery. Correct identification is important for appropriate treatment between cerebral infarction and cerebral hemorrhage. Herein, we present a case that followed lethal outcome due to misdiagnosis between epidural hematoma expansion and acute cerebral infarction caused by dissection or calcification of the internal carotid artery after blunt trauma. To the best of our knowledge, there have been any reports regarding simultaneous occurrence of acute cerebral infarction and acute epidural hematoma on the same side following blunt trauma.
Carotid Arteries ; Carotid Artery, Internal ; Cerebral Hemorrhage ; Cerebral Infarction* ; Consciousness ; Diagnostic Errors* ; Hematoma* ; Hematoma, Epidural, Cranial ; Prognosis ; Vascular Calcification