Romanian Neurosurgery (Jun 2016)
Factors affecting outcome in posterior fossa EDH
Abstract
Introduction. Posterior fossa extradural hematomas (PFEDHs) are uncommon as compared to supratentorial EDH and these patients can deteriorate very rapidly due to compression over brainstem. Thus early identification and intervention can save the lives of these patients. Methods. We prospectively studied 114 patients of posterior fossa injury for mode of injury, neurological status during admission, radiological findings, management, and outcomes of patients suffered posterior fossa extradural hematoma. All statistical analyses were determined using the SPSS 22.0.0.0 version. Statistical analysis was conducted utilizing Chi-square test. Results. Out of 114 posterior fossa trauma patients 28 patients (24.56%) having posterior fossa EDH. GCS on admission (p value=0.002), volume of posterior fossa EDH (p value= 0.000) were significant factors for the outcome of posterior fossa EDHs. On comparing the data patients who survived and those who did not survive, the GCS on admission (p value=0.004) and brain stem compression (p value=0.000) were two factors found to affect the mortality significantly. Conclusion. Early detection with high degree of suspicion and immediate evacuation of PFEDHs should be done if causing fourth ventricle, basal cistern or brain stem compression.
