Ossified chronic epidural hematoma of the posterior fossa
Ali Akhaddar, Omar Boulahroud
The Pan African Medical Journal. 2015;20:238. doi:10.11604/pamj.2015.20.238.3954

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Ossified chronic epidural hematoma of the posterior fossa

Cite this: The Pan African Medical Journal. 2015;20:238. doi:10.11604/pamj.2015.20.238.3954

Received: 03/02/2014 - Accepted: 21/10/2014 - Published: 13/03/2015

Key words: Chronic, epidural hematoma, posterior fossa

© Ali Akhaddar et al. The Pan African Medical Journal - ISSN 1937-8688. This is an Open Access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.

Available online at: http://www.panafrican-med-journal.com/content/article/20/238/full

Corresponding author: Ali Akhaddar, Department of Neurosurgery, Avicenne Military Hospital, Marrakech, Morocco (akhaddar@hotmail.fr)


Ossified chronic epidural hematoma of the posterior fossa

 

Ali Akhaddar1,2,&, Omar Boulahroud3

 

1Department of Neurosurgery, Avicenne Military Hospital, Marrakech, Morocco, 2University of Mohammed V Souissi, Rabat, Morocco, 3Department of Neurosurgery, Mohammed V Military Teaching Hospital, Rabat, Morocco

 

 

&Corresponding author
Ali Akhaddar, Department of Neurosurgery, Avicenne Military Hospital, Marrakech, Morocco

 

 

Image in medicine

A 15-year-old adolescent presented to us with mild headache, progressive dizziness and recent vomiting since 2 weeks without seizures. There was a history of head injury (neglected) following a stone-throwing incident 2 months earlier. On examination, he was conscious with a left cerebellar syndrome but without other neurologic deficit. Routine biologic data were normal. CT-scan revealed left posterior fossa extradural lesion with hypodensity in the center and calcified wall (A). MRI showed that the lesion was liquid with homogeneous ring enhancement following gadolinium injection and cerebellar compression (B and C). A sub-occipital craniotomy was done and a chronic liquefied hematoma was removed. There was a thick hard calcified wall relatively adherent to the duramater (D). Postoperative period was uneventful and the patient was discharged symptoms free. Histologically, the wall contains large areas of ossification. Ossified chronic epidural hematoma is a very rare complication following head injury. The blood accumulates slowly from a venous source becomes chronic extradural hematoma and becomes calcified or ossified due to an inflammatory reaction of the dura especially in children. This rare phenomenon should be considered in the differential diagnosis of other traumatic epidural and subdural hematomas.

Figure 1: Axial CT-scan. (A): revealing a left posterior fossa chronic extradural biconvex lesion with ossified wall (arrow). MRI: Axial T1-weighted image after gadolinium injection; (B): T2-weighted image; (C): fluid-liquid lesion with homogeneous ring enhancement and significant cerebellar compression; (D): operative view demonstrating the ossified wall (arrow) after superficial dissection from the duramater

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 


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