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Posterior Fossa Haematomas outcome Following Surgical Evacuation: A Prospective Study

Lakshman Rao Akyam, Assistant Professor, Department of Neurosurgery, Osmania Medical College and General Hospital, Hyderabad, Telangana 500095, India. , Lakshman Rao Akyam1 , Ramaneshwar K2 , Premjit Ray Mortha3 , Bhaskar Godugu4 , Abhishek Donthula5

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International Journal of Neurology and Neurosurgery 10(2):p 108-112, April - June 2018. | DOI: DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.10218.6

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Abstract

Objective: To evaluate the various outcome variables in posterior fossa haematomas following surgical evacuation.

Methods: This is a prospective study done from August 2013 to February 2016 done on 68 patients with posterior fossa EDH, traumatic cerebellar haematomas, brainstem contusions, spontaneous cerebellar haematomas, sub dural haematomas were initially resuscitated, examined and graded according to GCS. The patient was thoroughly investigated and underwent conservative management and surgical evacuation and outcome parameters were measured.

Results: The patients admitted were evaluated with the preoperative GCS, of which the score of 812 with good outcome is present in 10 patients (66%) (P value0.0414), and the haematoma size and volume was measured showing a good outcome in 9 patients (69%) (P value0.0490) and 5 patients (83%) (P value0.0493) of haematoma size of < 4cm and volume of < 15ml. The patient’s outcome was also measured by effacement of 4th ventricle, as the good outcome was seen in 14 patients (73%) (P value0.0161). External ventricular drinage was performed in 14 cases of associated hydrocephalus. Significant no. of patients (17) had a GOS of 5 at disharge and followup. The mortality rate of the study was 14%.

Conclusions: The preoperative GCS, clot size, clot volume and configuration of the fourth ventricle on CT scans is a useful sign and valuable in measuring the oucome of the patient to apply the various and the best management protocol. These outcome variables can definitely change the mortality and morbidity in posterior fossa haematomas.

Keywords: Posterior Fossa Haematoma; GCS; GOS. 

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DOI: DOI: http://dx.doi.org/10.21088/ijnns.0975.0223.10218.6

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