Traumatic Posterior Fossa Subdural Hygroma and Secondary Occlusive Hydrocephalus

Pediatr Neurosurg. 2017;52(5):336-342. doi: 10.1159/000479330. Epub 2017 Aug 25.

Abstract

Background: Infratentorial subdural hygromas causing secondary occlusive hydrocephalus are extremely rare in children. Only a handful of cases have been reported in the literature.

Methods: We present a case of a 6-month-old infant with an occipital fracture and slow enlargement of a posterior fossa subdural hygroma that culminated in obstructive hydrocephalus. We give a review of the literature on post-traumatic posterior fossa hygroma with secondary occlusive hydrocephalus and discuss its pathogenesis and the mechanism of its later resolution, as well as the available treatment options.

Results: A temporary external ventricular drain led to acute relief of the hydrocephalus and subsequent complete resolution of the subdural hygroma.

Conclusion: Temporary external ventricular drain placement led to complete resolution of the subdural hygroma and hydrocephalus. We recommend close clinical follow-up, and imaging if indicated, for as long as 4 weeks after trauma with occipital skull fractures.

Keywords: External ventricular drainage; Infratentorial hygroma; Occipital skull fractures; Pediatric trauma; Secondary occlusive hydrocephalus.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Cranial Fossa, Posterior / diagnostic imaging
  • Cranial Fossa, Posterior / injuries
  • Cranial Fossa, Posterior / surgery*
  • Humans
  • Hydrocephalus / diagnostic imaging
  • Hydrocephalus / etiology
  • Hydrocephalus / surgery*
  • Infant
  • Male
  • Skull Fractures / complications
  • Skull Fractures / diagnostic imaging
  • Skull Fractures / surgery*
  • Subdural Effusion / diagnostic imaging
  • Subdural Effusion / etiology
  • Subdural Effusion / surgery*