Traumatic retroclival epidural hematoma in pediatric patient--Case report and review of literature

Muhammadzubair Tahir,Gohar Javed,Sonia Hanif,Sa Quadri

doi:10.4103/2152-7806.82085

Muhammadzubair Tahir, Gohar Javed + Show 2 more

Open Access

https://doi.org/10.4103/2152-7806.82085

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Abstract

Background:Retroclival epidural hematoma (REDH) is a very rare entity in the practical field of neurosurgery. Only a few cases have been reported in literature. The authors present to you case of a 12-year-old female, a victim of road traffic accident (RTA), who had presented to us with loss of consciousness and seizures.Case Description:Magnetic resonance imaging revealed retroclival hematoma. She was managed on conservative grounds and discharged with assurance of multiple follow-up visits.Conclusion:Very few cases of REDH have been reported in pediatric population to date. It should be suspected in children with head and neck injuries who have been a victim of RTAs. Most likely underdiagnosed due to its rarity; therefore, MRI should be considered when the suspicion is high. Atlanto-occipital dislocation should always be kept under consideration in all cases, and therefore should be managed and monitored very cautiously. In this report, the authors also present concise review of the literature pertaining to the pathogenesis and management of this rare clinical entity which has a high likelihood to be encountered and underdiagnosed by neurosurgeons in Emergency Room.

Highlights

Retroclival epidural hematoma (REDH) is an infrequent diagnosis in the pediatric age group
Very few cases of REDH have been reported in pediatric population to date. It should be suspected in children with head and neck injuries who have been a victim of road traffic accidents (RTA)
We report to you the very first in this country along with a concise review of the literature focusing on the cause for a relatively high incidence in pediatric age group, pathophysiology, optimal approach, and management of this very rare entity with a high probability to be encountered and underdiagnosed by neurosurgeons when dealing with children who have been involved in an RTA

Summary

INTRODUCTION

Retroclival epidural hematoma (REDH) is an infrequent diagnosis in the pediatric age group. We report to you the very first in this country along with a concise review of the literature focusing on the cause for a relatively high incidence in pediatric age group, pathophysiology, optimal approach, and management of this very rare entity with a high probability to be encountered and underdiagnosed by neurosurgeons when dealing with children who have been involved in an RTA This 12-year-old female was hit by a speeding motor vehicle while crossing street. Magnetic resonance imaging (MRI) was done on the fifth day It confirmed the presence of retroclival hematoma and tiny petechial hemorrhages on left half of Pons and right thalamus [Figure 2]. A marked improvement was seen in the general health and the right-sided weakness over subsequent visits

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CONCLUSION