Rapid resolution of a traumatic venous epidural hematoma in a 3-year-old child: illustrative case

Florian Wilhelmy; Tim Wende; Johannes Kasper; Maxime Ablefoni; Lena Marie Bode; Jürgen Meixensberger; Ulf Nestler

doi:10.3171/CASE21413

Rapid resolution of a traumatic venous epidural hematoma in a 3-year-old child: illustrative case

J Neurosurg Case Lessons. 2021 Nov 22;2(21):CASE21413. doi: 10.3171/CASE21413.

Authors

Florian Wilhelmy¹, Tim Wende¹, Johannes Kasper¹, Maxime Ablefoni², Lena Marie Bode³, Jürgen Meixensberger¹, Ulf Nestler¹

Affiliations

¹ Departments of Neurosurgery.
² Pediatric Radiology, and.
³ Pediatric Surgery, University of Leipzig, Leipzig, Germany.

Abstract

Background: Posterior fossa epidural hematoma rarely occurs in children after traumatic head injury. There is ongoing discussion about appropriate treatment, yet the radiological features regarding the time to resorption of the hematoma or required follow-up imaging are rarely discussed.

Observations: The authors presented the case of a 3-year-old child who was under clinical observation and receiving analgetic and antiemetic treatment in whom near-complete hematoma resorption was shown by magnetic resonance imaging as soon as 60 hours after diagnosis. The child was neurologically stable at all times and showed no deficit after observational treatment. Hematoma resorption was much faster than expected. The authors discussed hematoma drainage via the sigmoid sinus.

Lessons: Epidural hematomas in children can be treated conservatively and are resorbed in a timely manner.

Keywords: CT = computed tomography; EDH = epidural hematoma; MRI = magnetic resonance imaging; PFEDH = posterior fossa epidural hematoma; epidural hematoma; observation; pediatric; resorption; trauma.

Publication types

Case Reports