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Vol 47, N° 2-3  - juin 2001
p. 105
Doi : NCHIR-05-2001-47-2-3-C1-0028-3770-101019-ART7
Communication brève

Hématome extradural de la fosse postérieure
Vingt observations anatomo-cliniques

A. Kabre [1], J.-R. Alliez [1], J.-M. Kaya [1], G. Bou Harb [1], Y. Reynier [1], B. Alliez [1]
[1] Service de Neurochirurgie (Pr B. Alliez), Hôpital Nord, Chemin des Bourrely, 13915 Marseille Cedex 20.

Extradural hematoma of the posterior fossa. A series of 20 consecutive cases

Extradural hematoma of the posterior fossa (EDHPF) is considered to be a rare complication of head injuries. In early reports, diagnosis was made only at the time of autopsy. Today, CT scanning prompts early diagnosis leading to better outcome. We report 20 consecutive patients observed over the last ten years who underwent surgery for EDHPF. This localization was found in 14,3 % of all trauma patients operated for extradural hematoma.

In our experience, EDHPF occurs in young adults with a clear male predominance. Vehicle accidents are the most frequent mechanism of injury. The main clinical presentation is subacute onset of signs (50 % of our cases). Postoperative outcome was favorable in 19 of our patients (95 %). We propose mandatory CT scanning that may have to be repeated as needed, to prevent delay in diagnosis and decision for surgery. Surgical removal of the EDHPF must be carried out as soon as possible as this is the only way to reduce morbidity and mortality.


L'hématome extradural de la fosse postérieure (HEDFP) est une complication rare, mais non exceptionnelle, des traumatismes crânio-encéphaliques. Longtemps reconnu ou diagnostiqué tard, au stade ultime, l'HEDFP a vu son pronostic radicalement transformé par l'avènement du scanner. Nous rapportons notre expérience à propos de 20 cas opérés. Les aspects épidémiologiques, anatomo-cliniques et thérapeutiques sont analysés.

Dans notre expérience, l'HEDFP représente 14,3 % des hématomes extraduraux (HED) opérés. Il existe une prédominance masculine nette et, dans 1 cas sur 2, il s'agit d'un adulte jeune, victime d'un accident de la circulation. Sur le plan clinique, la forme subaiguë est la plus fréquente (50 %). Les résultats à long terme sont bons dans 95 % des cas. Les auteurs insistent sur l'intérêt des examens tomodensitométriques répétés, débouchant sur un diagnostic précoce et un traitement chirurgical adéquat, permettant de réduire ainsi la mortalité.

Keywords: extradural hematoma. , cranial posterior fossa. , cranial CT scan. , lateral sinus .

© 2001 Elsevier Masson SAS. Tous droits réservés.
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