Injuries of the posterior cranial fossa

Krylov V.V., Talypov A.E., Ioffe Yu.S., Kuksova N.S.

(Department of Emergency Neurosurgery, Sklifosovsky Research Institute of Emergency Care, Moscow, Russia)

Injuries of the posterior cranial fossa (PCF) are a rare type of craniocerebral trauma. They are characterized by difficulties, experienced during clinical diagnosis, and high mortality.

There were 56 patients with injuries of PCF, treated in the Department of Emergency Neurosurgery of the Sklifosovsky Research Institute of Emergency Care in 1990-2000. They accounted for 0.9% of all cases with craniocerebral trauma. Epidural hematomas were watched in 50% of PCF injuries. Subdural hematomas of PCF manifested themselves only in the form of adjacent intracerebellar hematomas. Supratentorial spread of epidural hematomas of PCF was watched in 12 out of 28 cases. Associated suptratentorial injuries were diagnosed in 64% of casualties. Acute occlusive hydrocephalus developed in 37% of patients.

Clinical and instrumental methods (craniography, ASEVP, neuroophthalmologic examination) were the basis for determining versions of a clinical course of PCF injuries and types of surgical treatment. Operations were performed in 26 cases (1.9% of all operated patients with craniocerebral trauma). Results of surgical treatment, causes of mortality and factors, aggravating outcomes of PCF injuries, were analyzed.