Posterior Fossa Subdural Hematoma Research Articles

Management and Outcomes of Posterior Fossa Subdural Hematomas in Neonates

Management and Outcomes of Posterior Fossa Subdural Hematomas in Neonates

CONSERVATIVE TREATMENT OF A TRAUMATIC SUBDURAL HEMATOMA OF THE POSTERIOR FOSSA IN A CHILD

Traumatic posterior fossa hematomas are uncommon. Subdural hematomas in this location are probably the rarest. The natural history in acute cases is one of rapid deterioration and death from brain-stem compression. Rapid surgical intervention is indicated in acute cases. We report a case of a traumatic posterior fossa subdural hematoma in a 3-year-old child treated conservatively with a good outcome.

Increased middle cerebral artery blood flow impedance in fetal subdural hematoma.

This case describes the prenatal diagnosis at 30 weeks' gestation of a posterior fossa subdural hematoma. Doppler velocimetry studies of the middle cerebral artery at that time showed an abnormally high resistance pattern with reverse end-diastolic flow. Ultrasonic assessment of the fetus indicated that there was associated quadriplegia. No cause for the lesion was demonstrated. A fetal blood sample, obtained by cordocentesis, revealed a normal karyotype. Fetal blood gas analysis was also normal. The pregnancy was terminated at the parents' request.

Tentorial subdural hemorrhage in term newborns: Ultrasonographic diagnosis and clinical correlates

Tentorial subdural hemorrhage with its supratentorial and infratentorial extensions were diagnosed by cranial ultrasonography and computed tomography in 9 term newborns. Vacuum extraction or forceps delivery was used in 6 patients. Abnormal neurologic manifestations developed after a period of normality in 8 patients. Increased intracranial pressure was the most common presentation. All patients had hemorrhage at the falcotentorial junction near the incisura; 5 also had hemorrhage around the tentorial leaflet. Posterior fossa retrocerebellar subdural hemorrhage developed in 5 patients and posterior interhemispheric subdural hemorrhage developed in 4. All 6 patients who received conservative treatment had normal neurodevelopmental outcomes. Of the other 3 patients upon whom suboccipital craniotomies were performed, only 1 had a normal outcome. Although it localized the tentorial subdural hemorrhage either at the incisura area or at the tentorial leaflet, ultrasonography failed to identify all patients with retrocerebellar or posterior interhemispheric subdural hemorrhage. Parturitional tentorial subdural hemorrhage may not be uncommon. Ultrasonography and computed tomography are complementary in the diagnosis. Surgical decompression of the posterior fossa subdural hematoma is necessary only in the presence of acute hydrocephalus or signs of brainstem compression.

Biphasic ventricular dilatation following posterior fossa subdural hematoma in the full-term neonate.

Five full-term neonates with a posterior fossa subdural hematoma caused by birth injury are reported. All of the patients were successfully treated with surgery. They all presented with biphasic ventricular dilatation as demonstrated by serial computerized tomography (CT) scanning. The initial dilatation due to obstructive hydrocephalus disappeared after removal of the hematoma; however, a second dilatation without obstruction of the ventricular system developed between 2 and 4 weeks after surgery. A ventriculoperitoneal shunt was required in one case because of progressive enlargement of the head size in the chronic stage. The other four patients showed transient dilatation of the ventricles without symptoms of increased intracranial pressure. Subarachnoid hemorrhage associated with posterior fossa subdural hematoma is considered to be the most likely causative factor for the delayed ventricular dilatation. The degree of dilatation roughly depended on the volume of the subarachnoid clot that was demonstrated on the initial CT scan.

Spontaneous posterior fossa subdural hematoma as a complication of anticoagulation

Spontaneous posterior fossa subdural hematoma as a complication of anticoagulation

Posterior Fossa Subdural Hematoma in the Newborn With Special Reference to Operative Indication

Posterior Fossa Subdural Hematoma in the Newborn With Special Reference to Operative Indication

Retroauricular cephalhematoma as a sign of posterior fossa subdural hematoma: Diagnosis in the newborn by tomography: R. S. K. Young and E. L. Zalneraitis. Clin Pediatr 19:631–632, (September), 1980

Retroauricular cephalhematoma as a sign of posterior fossa subdural hematoma: Diagnosis in the newborn by tomography: R. S. K. Young and E. L. Zalneraitis. Clin Pediatr 19:631–632, (September), 1980

Posterior Fossa Subdural Hemorrhage in the Newborn

Posterior fossa subdural hematoma formation in the newborn is an infrequently reported event. It is characterized by a complicated delivery, usually at term, followed by developing lethargy and irritability within the first few days of life. Respiratory irregularities, tense anterior fontanelle, and increasing head circumference ensue, accompanied by a falling hemoglobin and blood-stained cerebrospinal fluid. Various cranial nerves may also be involved. Previously reported cases have been marked by diagnostic delays that affected the subsequent outcome of some of the patients. Computed tomography (CT) allows for earlier confirmation of the diagnosis, especially where coronal views are employed. Three cases are reported here to illustrate the above features.

Posterior fossa subdural hematoma of the newborn. Case report.

✓ A newborn infant with a posterior fossa subdural hematoma is described, and nine similar cases from the literature summarized. A postnatal asymptomatic period was followed by signs of increased intracranial pressure. The diagnosis was established on the basis of negative subdural taps, bloody or xanthochromic ventricular fluid under increased pressure, and demonstration of a posterior fossa mass on the ventriculogram. Surgical evacuation with careful observation for an associated intracerebellar hematoma is the treatment of choice. Five of the 10 cases developed postoperative communicating hydrocephalus.