Abstract
Background Liquid posterior fossa epidural hematoma (LPFEH) following head trauma is uncommon,
and very few such cases have been described in the literature. Eight patients with
this entity and their treatments are presented here.
Methods We performed a single-institution retrospective analysis of all patients with diagnosed
LPFEH over a 3-year period. Collected data included clinical history, laboratory results,
treatment, and review of all imaging studies performed.
Results Eight pediatric cases were identified with imaging findings consistent with LPFEH;
no adult case was identified. Enlargement of ventricles appeared on computed tomography
(CT) in six cases, and secondary epilepsy onset occurred in three cases with severe
dilated ventricles. Routine hematologic and coagulation tests failed to disclose anemia
or abnormal coagulation in each case. Five patients underwent burr-hole drainage of
the hematoma and recovered completely. Conservative therapy was adopted in three patients
for small hematomas, and hematoma enlargement was not observed in the follow-up CT
scans.
Conclusions LPFEH is a rare subtype of traumatic epidural hematoma specifically recognized in
the pediatric population. Minimally invasive burr-hole drainage is a feasible procedure
for the patient with evident space-occupying effect. Coagulation dysfunction or low
hemoglobin as a possible contributing factor and its role in formation of LPFEH was
excluded.
Keywords
computed tomography - pediatric - epidural hematoma - liquid - posterior fossa
