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CC BY 4.0 · Indian Journal of Neurotrauma
DOI: 10.1055/s-0044-1779431
Review Article

Supra- and Infratentorial Extradural Hematoma: A Series of Three Cases with Literature Review

Nitish Ranjan
1   Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
,
Ved Prakash Maurya 
1   Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
,
Kamlesh Singh Bhaisora
1   Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
,
Pawan Kumar Verma
1   Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
,
Raj Kumar
1   Department of Neurosurgery, Sanjay Gandhi Postgraduate Institute of Medical Sciences, Lucknow, Uttar Pradesh, India
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Abstract

The extradural hematoma (EDH) of the posterior fossa is a rare clinical condition in head injury cases. The posterior fossa extradural hematoma (PFEDH) contributes to not more than 4 to 8% of all the EDH encountered in traumatic brain injury. The limited volume of the posterior fossa leads to early clinical deterioration and, if not subjected to timely intervention, may be fatal. This rapid deterioration is because of significant compression over the brainstem and cervicomedullary junction as well as obstructive hydrocephalus. The PFEDHs are often associated with fracture of the occipital bone, which may lead to the extension of hematoma in the supratentorial and infratentorial spaces. The traumatic supra- and infratentorial EDH (TSIEDH) constitutes less than 2% of all the EDH. Limited literature is available regarding TSIEDH, and the majority are in the form of isolated case reports. We share our experience of three cases over the last 5 years from a tertiary care referral institute with a literature review of TSIEDH. Two of these cases were managed nonoperatively, and one underwent surgical evacuation of hematoma. In the present study, we share our experience regarding prompt diagnosis and management of this particular subset of traumatic brain injury patients. We also describe the surgical technique for evacuation of TSIEDH. Early diagnosis and prompt surgical intervention can be life-saving as these hematomas may have a benign clinical presentation but rapid clinical deterioration.

Keywords

extradural hematoma - supratentorial - infratentorial - evacuation - traumatic brain injury


Publication History

Article published online:
14 February 2024

© 2024. The Author(s). This is an open access article published by Thieme under the terms of the Creative Commons Attribution License, permitting unrestricted use, distribution, and reproduction so long as the original work is properly cited. (https://creativecommons.org/licenses/by/4.0/)

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