Posterior fossa (venous) extradural hematoma in a child
Recent head strike, now drowsy and headache.
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Biconvex extra-axial mass of heterogeneous T1 and T2 signal (including T1 hyperintensity and susceptibility artefact on SWI indicative of blood) overlying the left cerebellar hemisphere, entering the supratentorium displacing the dura anteriorly. No obvious overlying fracture or scalp swelling/hematoma. Focal mass effect.
Extradural hematoma is much less commonly seen in the posterior fossa than supratentorium (usually in the middle cranial fossa). The hematoma has the typical lentiform shape (bi-convex) of extradural hemorrhage and strips the dura anteriorly as evidenced by displacement of the transverse sinus anteriorly (arrow). Origin of the bleeding is presumed to be due to disruption of the sinus, i.e. venous bleeding.
- Ammirati M, Tomita T. Posterior fossa epidural hematoma during childhood. (1984) Neurosurgery. 14 (5): 541-4. Pubmed