Posterior fossa epidural hematomas in children: a clinical analysis of 35 cases

Abstract

Objective To investigate the clinical features, imaging findings, treatment and prognosis of posterior fossa epidural hematomas in children. Methods From August 2010 to April 2015, the clinical data of 35 children with traumatic posterior fossa epidural hematoma admitted to the Department of Neurosurgery, the Affiliated Hospital of Xuzhou Medical College were analyzed retrospectively. Eighteen of them were treated conservatively 8 were treated with skull drilling and drainage. Three of which received urokinase therapy because part of residual hematoma after procedure, and 9 were treated by craniotomy. Results In 18 children treated with the conservative treatment, CT revealed that their hematomas were absorbed about 1 month or so after symptom onset. The residual hematomas <5 ml after procedure in 8 children were treated with skull drilling and drainage, and 9 were treated with craniotomy, their hematomas were removed completely after procedure. They were followed up for 4 months to 5 years. All children recovered well, without operation death and disability. Conclusions The occurrence of posterior fossa epidural hematomas in children are relatively more common. Most of them are falling and slipping injuries. The lambdoid suture separation fracture and occipital fracture are the main causes of bleeding. Headache, vomiting and disturbance of consciousness are more important for identifying the disease. Hemotomas in acute phase are easy to be liquefied. Drilling skull and drainage are safe and effective for the treatment of liquefied hematomas. The early diagnosis and appropriate treatment of posterior fossa epidural hematomas in children have good prognosis. Key words: Hematoma, epidural, cranial; Child; Treatment