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Case Reports
. 2021 Nov 22;2(21):CASE21413.
doi: 10.3171/CASE21413.

Rapid resolution of a traumatic venous epidural hematoma in a 3-year-old child: illustrative case

Florian Wilhelmy  1 , Tim Wende  1 , Johannes Kasper  1 , Maxime Ablefoni  2 , Lena Marie Bode  3 , Jürgen Meixensberger  1 , Ulf Nestler  1
Affiliations
Case Reports

Rapid resolution of a traumatic venous epidural hematoma in a 3-year-old child: illustrative case

Florian Wilhelmy et al. J Neurosurg Case Lessons. .

Abstract

Background: Posterior fossa epidural hematoma rarely occurs in children after traumatic head injury. There is ongoing discussion about appropriate treatment, yet the radiological features regarding the time to resorption of the hematoma or required follow-up imaging are rarely discussed.

Observations: The authors presented the case of a 3-year-old child who was under clinical observation and receiving analgetic and antiemetic treatment in whom near-complete hematoma resorption was shown by magnetic resonance imaging as soon as 60 hours after diagnosis. The child was neurologically stable at all times and showed no deficit after observational treatment. Hematoma resorption was much faster than expected. The authors discussed hematoma drainage via the sigmoid sinus.

Lessons: Epidural hematomas in children can be treated conservatively and are resorbed in a timely manner.

Keywords: CT = computed tomography; EDH = epidural hematoma; MRI = magnetic resonance imaging; PFEDH = posterior fossa epidural hematoma; epidural hematoma; observation; pediatric; resorption; trauma.

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Conflict of interest statement

Disclosures The authors report no conflict of interest concerning the materials or methods used in this study or the findings specified in this paper.

Figures

FIG. 1.
FIG. 1.
CT scan approximately 1 hour after initial trauma A: Axial CT showing the left occipital PFEDH, reaching the supratentorial space (arrow). Volume ∼11 cm3. Sagittal (B) and axial (C) images of bone window with parasagittal fracture (arrows). D: Coronal image. Bone window showing the fracture line crossing the sinusoidal groove of the occipital bone (arrow).
FIG. 2.
FIG. 2.
MRI scans approximately 4 hours after initial trauma (A and B) and 60 hours after initial trauma (C and D). Prevalent strabism. A: Axial view, T2-weighted image. The PFEDH is visualized with an approximate volume of 12 mL (arrow). B: Sagittal view. Extension to the supratentorial space, crossing the transverse sinus (arrow). C: Axial MRI at follow-up showing the resorption of the hematoma (arrow). Residual volume of the now T2-hypointense clot is 4.5 mL. D: Sagittal T2-weighted image confirming near-complete absorption (arrow).
See this image and copyright information in PMC

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References

    1. Sencer A, Aras Y, Akcakaya MO, Goker B, Kiris T, Canbolat AT. Posterior fossa epidural hematomas in children: clinical experience with 40 cases. J Neurosurg Pediatr. 2012;9(2):139–143. - PubMed
    1. Sheng H-S, You C-G, Yang L, et al. Trephination mini-craniectomy for traumatic posterior fossa epidural hematomas in selected pediatric patients. Chin J Traumatol. 2017;20(4):212–215. - PMC - PubMed
    1. Chaoguo Y, Xiu L, Liuxun H, Hansong S, Nu Z. Traumatic posterior fossa epidural hematomas in children: experience with 48 cases and a review of the literature. J Korean Neurosurg Soc. 2019;62(2):225–231. - PMC - PubMed
    1. Jamous MA, Samara QA, Jbarah OF, Ahmed YB. Management of traumatic posterior fossa epidural hematomas in pediatrics: our experience and review of the literature. Childs Nerv Syst. 2021;37(9):2839–2846. - PubMed
    1. Baş NS, Karacan M, Doruk E, Karagoz Guzey F. Management of traumatic epidural hematoma in infants younger than one year: 50 cases—single center experience. Pediatr Neurosurg. 2021;56(3):213–220. - PubMed

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