Post-traumatic bilateral epidural hygroma of posterior cranial fossa: case report and brief review of literature.

Post-traumatic bilateral epidural hygroma of posterior cranial fossa: case report and brief review of literature.

World Neurosurg. 2015 Dec 23;

Authors: Kumar J, Harsh V, Strickland BA, Sahay CB, Kumar A

Abstract
BACKGROUND: Post-traumatic posterior fossa epidural hygroma is a rare entity without a clear management established in the medical literature. We present one such case and review the literature relevant to this unusual entity. An attempt to outline the mechanism of formation and management of posterior cranial fossa epidural hygroma is also made.
CASE DESCRIPTION: Two-year old child presents after a rooftop fall injury with symptoms of headache, drowsiness, vomiting, and brief loss of consciousness. The left occipital region demonstrated swelling, found to have epidural hygroma via CT scan. After failing conservative management, surgical repair of the dura was performed. The child was discharged post-operative day eleven in stable condition with marked improvement in occipital swelling.
CONCLUSIONS: It is imperative to consider epidural hygroma in very small children presenting with occipital injury. Owing to loose adhesion of dura and internal cranial lamina layers in younger pediatric population, potential epidural space may be easily created due to injury and small breaches in meningeal integrity near the cisterna magna may favor CSF leak. During operation if water-tight repair of visible dural tear is performed, duro-periosteal hitching or vacuum drain placement may not be required.

PMID: 26723294 [PubMed - as supplied by publisher]

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