Abstract
A case of acute epidural hematoma of the posterior fossa caused by fronto-temporal impact was reported. A 43-year-old man hit the right fronto-temporal region against the pole on the road, while driving a motorcycle after drinking. Immediately after the injury, he was conscious, but disoriented and was brought to a local hospital 30 minutes after the accident. He was then confused and was treated by mannitol and steroid. The patient was transferred 36 hours after injury because he remained somnolent of stuporous. On admission, a swelling of the right fronto-temporal region was noticed. Plain skull X-ray failed to reveal a skull fracture, other than equivocal skull depression at the right fronto-temporal region. Computed tomography scan demonstrated a biconvex hyperdense lesion in the right posterior fossa which extended to the supratentorial region. Surgery disclosed a 20 g epidural hematoma of the right posterior fossa and the supratentorium and the clot was completely evacuated. The source of bleeding could not be identified. Opening of the posterior fossa dura revealed no abnormality in the subdural space or cerebellar surface. The postoperative course was uneventful and the patient was discharged without any neurological deficits. The possible mechanisms in the production of the posterior fossa hematoma in this case is discussed.
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