Traumatic posterior fossa epidural hematoma in patient with mega cisterna magna

Abstract

Background: Posterior fossa extradural hematoma is unusual among head injuries and represents about 4%-7% cases of all epidural hematomas. This study presented a case of traumatic posterior fossa epidural hematoma in patients with mega cisterna magna. Case Presentation: A 32-year-old male patient was examined after a fall from 3 m height. His brain computed tomography (CT) scan showed moderate to large acute epidural hematoma present in the left side of posterior fossa measuring about 16 ml volume, 10 mm in maximal thickness, and extended upwards across the ipsilateral left transverse and adjacent sigmoid dural venous sinuses to the left occipital region. It was associated with compression on the adjacent left occipital lobe. In addition, the focal enlargement of the subarachnoid space in the posterior and interior aspect of the posterior fossa was suggestive of mega cisterna magna. The patient was admitted to the intensive care unit (ICU) and follow-up CT scan of the brain was done but no interval changes were shown. Conclusion: Epidural hematoma of the posterior fossa needs a prompt intervention. Patients who present with mega cisterna magna could have better prognosis due to the larger posterior fossa space that helps in the expansion of the hematoma.