A Pediatric Case of Acute Epidural Hematoma in the Posterior Fossa in Which Mainly Isodense Hematoma was Visualized

A 6 year-old girl suffered an occipital hit with loss of consciousness at that time and vomiting. She was admitted to our hospital one day after injury for repeated vomiting. The patient was alert and indicated no obvious neurological deficits. Laboratory findings showed no anemia and hypoproteinemi...

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Bibliographic Details
Published in:Nihon Kyukyu Igakukai Zasshi 2006/03/15, Vol.17(3), pp.104-108
Main Authors: Uzura, Masahiko, Uchida, Kazuyoshi, Matsuzawa, Motoshi, Hashimoto, Takuo, Minowa, Yoshiyuki, Akashi, Katsuya
Format: Article
Language:English
Subjects:
acute epidural hematoma
conservative treatment
isodense hematoma
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Summary:A 6 year-old girl suffered an occipital hit with loss of consciousness at that time and vomiting. She was admitted to our hospital one day after injury for repeated vomiting. The patient was alert and indicated no obvious neurological deficits. Laboratory findings showed no anemia and hypoproteinemia. However, coagulation studies were not performed. The CT scan one day after injury showed an extra-axial biconvex isodense mass in the right posterior fossa. Repeated CT scan five days after injury showed no enlarged isodense mass, and MRI 12 days after injury revealed epidural hematoma without intraaxial pathology. Acute isodense epidural hematoma is very rare in the acute phase after injury. The mechanism of different densities is still unknown and possible causes include coexistence of fresh blood and clotted blood, decrease in hemoglobin and hematocrit, extravasated blood consisting of low attenuating protein, and mixture of blood with cerebrospinal fluid due to dural tears. We suggest that the acute isodense epidural hematoma in our case may be caused by blood with cerebrospinal fluid.
ISSN:0915-924X
1883-3772
DOI:10.3893/jjaam.17.104