Traumatic Epidural Hematoms in Posterior Cranial Fossa: a Clinical Study in Tertiary Care Hospital

Objective: To determine clinical presentation and outcome of traumatic epidural hematoma in posterior cranial fossa. Material and Methods: This descriptive case series was conducted in department of Neurosurgery Mardan Medical Complex Mardan from May 2016 to April 2017. All patients presenting with extradural hematoma in posterior fossa of either gender and age were included in the study while patients with recurrent posterior fossa extradural hematoma and hematoma at other side of the brain were excluded. CT scan Brain with bone window was done in all patients. Patients were followed for one month. Outcome was measured on the basis of GCS and GOS. Results: Total 23 patients were included in the study having age range from 8 to 58 years with mean age was34 ± 5.23 years. 16 (69.56%) were males and 7 (30.4%) were female. Road traffic accident was the most common cause of head injury in 11 (47.8%) cases. Headache and vomiting was seen in 16 (69.5%) cases, drowsiness in 8 (33%), occipital swelling in 4 (19%), otorrhea in 3 (13%) and coma in 1 (4%) case. 11 (47.8%) were managed conservatively while 12 (52.1%) were manage by surgery. Outcome measured by GOS, 15 (65.2%) fell into GOS 5, 3 (13.04%) fell into GOS 4, 7 (30.4%) into GOS 3, 6(26%) into GOS 2 and 6 (26%) into GOS 1. Conclusion: PFEDH is a traumatic substrate with poor clinical picture. Failure to diagnose the condition, level of consciousness at the time of intervention, clinical course and associated cranial injuries are the significant factors influencing morbidity and mortality from this condition. One should maintain high index of suspicion for the possibility of PFEDH in any patient with head injury