Posterior fossa subdural hematoma

see Spontaneous posterior fossa subdural hematoma.

see Traumatic posterior fossa subdural hematoma.

Posterior fossa subdural hematoma cases account for approximately 0.2% ¹⁾ of all head traumas and 0.3-3% ²⁾ ³⁾ of the traumatic subdural hematomas.

Rarely, subdural hematomas may be spontaneous, with no previous trauma. These cases are usually secondary to bleeding from an underlying pathology such as arteriovenous malformation (AVM), tumor or coagulation dysfunction ⁴⁾ ⁵⁾ According to the medical literature, only five cases of acute spontaneous subdural hematomas in the posterior fossa were reported ⁶⁾ ⁷⁾.

The low rate of occurrence of this type of hematoma in the posterior fossa could be explained by the few number of bridging veins in this region and the uncommon direct damage to the occipital dural sinus ⁸⁾ ⁹⁾.

Moreover, Goldsmith and Plunkett hypothesize that since the posterior fossa space is almost completely fulfilled by the brainstem and cerebellum, the movement of the skull base is synchronic to those structures, therefore no shear forces occur in this compartment ¹⁰⁾.

¹⁾ , ⁶⁾

Pal, D; Gnanalingham, K; Peterson, D; A case of spontaneous acute subdural haematoma in the posterior fossa following anticoagulation.

²⁾

Borzone M, Rivano C, Altomonte M, Baldini M. Acute traumaticposterior fossa subdural haematomas. Acta Neurochir (Wien). 1995;135:32–37.

³⁾ , ⁸⁾

Hec´imovic´ I, Blagus G, Kristek B, Rukovanjski M, Vrankovic´ D. Successful treatment of traumatic acute posterior fossa subdural hematoma: report of two cases. Surg Neurol. 1999; 51:247–251.

⁴⁾ , ⁹⁾

Stendel R, Schulte T, Pietilä A, Suess O, Brock M. Spontaneous bilateral chronic subdural haematoma of the posterior fossa. Case report and review of the literature. Acta Neurochir(Wien) 2002;144:497–500.

⁵⁾

M. Berhouma, S. Houissa, H. Jemel, M. Khaldi. Spontaneous chronic subdural hematoma of the posterior fossa. Journal of Neuroradiology. 2007;

⁷⁾

McClelland, R.R; Ramirez-Lassepas, M. Posterior fossa subdural hematoma demonstrated by vertebral angiography. Neurorradiology 1976. 10,181-185.

¹⁰⁾

Goldsmith, W; Plunkett, J. A Biomechanical Analysis of the Causes of Traumatic Brain Injury in Infants and Children. The American Journal of Forensic Medicine and Pathology. 25:2.2004