Traumatic posterior fossa epidural hematomas

Özkan ATEŞ, Şevket TEKTAŞ, Ayhan KOÇAK, S. Çağatay ÖNAL, Özcan TARIM, Süleyman R. ÇAYLI

Abstract

Aim: The purpose of the study was to establish the prognostic factors and curative criteria on the management of posterior fossa epidural hematomas. Material and Methods: This study consisted of 14 (17%) posterior fossa epidural hematoma cases out of 82 traumatic epidural hematoma patients admitted to İnönü University School of Medicine, Department of Neurosurgery in a four-year-period between January 1998 to January 2002. The patients were evaluated regarding age, gender, type of trauma, hematoma volume, Glasgow Coma Score (GCS) in admittance, symptoms and signs, concomittant pathology, surgical treatment and Glasgow Outcome Scale (GOS). Results: 57.1% of the cases were male and 42.9% of the cases were female. Average age was 11.1 years and 78.6% of the cases were in the pédiatrie age group. 85.7% of the cases were admitted in the first twenty-four hours. The most frequent etiology was fall (71.4%) and 64.3% of the patients had a GCS of 13-15 in admittance. The most frequent symptom was headache (71.4%). All the cases had occipital linear fracture and none of them deceased. Conclusion: Surgical management of posterior fossa epidural hematomas require a thorough evaluation of the level of consciousness, cranial computerized tomography findings, and hematoma volume.

Özet

Amaç: Travmatik posterior fossa epidural hematomlaıında tedavi kriterleri ve prognostik faktörlerin saptanması. Gereç ve Yöntem: Bu çalışmada Ocak 1998- Ocak 2002 tarihleri arasında İnönü Üniversitesi Tıp Fakültesi Nöroşirurji Anabilim Dalı'nda takip ve tedavisi yapılan 82 travmatik epidural hematom (EDH) olgusundan posterior fossa lokalizasyonlu 14'ü (%17) yaş, cinsiyet, travmanın oluş şekli, hematom hacmi, başvuru Glasgow Koma Skoru (GKS), başvuru şikayeti, muayene bulguları ek patoloji varlığı, cerrahi müdahale, Glaskow Outcome Skoru (GOS) açısından incelenmiştir. Bulgular: Olguların %57,1'i erkek, %42