Traumatic hematomas of the posterior cranial fossa.

The objective of this study was to find out the result of treatment and the factors which can predict the outcome of traumatic hematomas of the posterior cranial fossa. Twenty two patients with traumatic hematomas of the posterior cranial fossa from 1,500 patients with traumatic intracranial hematomas were analyzed. There were fourteen male and eight female patients. The most common etiology was a motor vehicle accident. About 90 per cent of the patients had a direct injury to the occipital region. Ninety per cent of the patients had an occipital skull fracture or diastatic fracture of the lambdoid suture. The overall mortality rate was about 38 per cent. Patients having pure epidural hematoma had zero mortality. By contrast, patients suffering epidural hematoma with associated intracranial hematoma had 20 per cent mortality. Intracerebellar hematoma led to 60 per cent mortality. Glasgow Coma Scale (GCS) before operation was used to predict the patients' outcome. Ninety per cent of the patients who had a GCS between 13 and 15 had a good recovery. By contrast, only 30 per cent of the patients who had a GCS below 9 had a good recovery. Statistical analysis showed that the GCS value of below 9 predicted the poor outcome for the patients.