Traumatic Posterior Fossa Epidural Hematomas and Their Complications

Background: Traumatic posterior fossa epidural hematomas (TPFEDH) occur infrequently however their mortality and morbidity are higher than supratentorial epidural hematomas. Signs and symptoms may be silent or nonspecific, even though they may show rapid progression and deterioration from consciousness to coma, thus they would cause fatal results. Recently, practice of computerized tomography (CT) has grown up and replaced the use of direct X-ray to detect calvarial fractures and other traumatic pathologies, therefore patients with posterior fossa trauma were diagnosed earlier.Material and Methods: We presented eight cases who suffered from TPFEDHs treated in our clinics between the years 2002 and 2006. Five cases were operated immediately however 3 cases were treated conservatively. One of the operated cases died immediately after surgery. Postoperative complications of cerebral sinus thrombosis and pseudomeningocele were observed in two cases. Alive cases were discharged a few days after surgery.Conclusion: Mortality decreases in TPFEDHs since they could be diagnosed earlier with widespread use of CT and treated successfully. In addition, it is easier to decide whether conservative or surgical therapy is efficient because CT findings should correlate with clinical findings. However, few complications such as cerebral sinus thrombosis and pseudomeningocele occur infrequently. Furthermore these cases must be monitored carefully during postoperative period for a new neurological finding.