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Japanese

ACUTE POSTERIOR FOSSA EXTRADURAL HEMATOMAS: THE DIAGNOSTIC VALUE OF VERTEBRAL ANGIOGRAPHY Junkoh Yamashita 1 , Koreaki Mori 2 , Hideo Satoh 1 , Yasuaki Yoshida 1 , Taro Fukumitsu 1 1Department of Neurosurgery, Shizuoka Rosai Hospital pp.277-282
Published Date 1970/3/1
DOI https://doi.org/10.11477/mf.1406202690
  • Abstract
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Extradural hematoma of the posterior fossa is a rare clinical entity. As a rule this lesion has been overlooked because of the paucity of neurologic signs and symptoms or diagnosed so late that opera-tion was of no avail. It is also very possible that it might be missed entirely unless one is not alert to the possibility. To date we have found a little more than one hunderd cases in the literature. In Japan four cases have been reported among which only one was successfully treated surgically.

We are reporting two cases of acute posterior fossa extradural hematoma whose lesions were de-monstrated by direct percutaneous vertebral angio-graphy. The one was operatively treated with success and the other died after the operation.

Obviously, when the clinical signs and symptoms of a posterior fossa traumatic hematoma are pro-gressing very rapidly, there may not be time for vertebral angiography. However, we feel that when angiography is feasible, it is the procedure of choice when one is faced with the possibility of a lesion in this location. Our cases demonstrate that pos-terior fossa hematoma can be readily visualized by vertebral angiography. The knowledge of a precise localization of the lesion can be of great assistance to the surgeon in planning his surgical attack.

We believe that our technique of direct percu-taneous vertebral angiography is particularly useful in emergency cases because the technique is simple and the instruments can be the same as those of carotid angiography.

Once the diagnosis is established, the patient should be operated upon as early as possible. Success of surgery exclusively depends on how to repair dural sinus laceration.


Copyright © 1970, Igaku-Shoin Ltd. All rights reserved.

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電子版ISSN 2185-405X 印刷版ISSN 0006-8969 医学書院

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