Unusual localization and evolution in the posterior cerebral fossa of an adult post-traumatic acute subdural hematoma.

Abstract

Introduction Acute subdural hematoma is the formation of a pocket of blood in the subdural space within 72 hours following a head trauma. The location in the posterior fossa cerebrica is rare. The subdural hematoma of the inter‑hemispheric region or tent of the cerebellum is clinically characterized by a kinetic and static cerebellar syndrome. These hematomas are associated with risks of cerebral involvement through intracranial hypertension and brain stem compression. These lesions are generally of small thickness and are not surgical except in special cases, which make spontaneous evolution possible. We present an exceptional location of the posterior cerebral fossa post‑traumatic in an adult with a favourable spontaneous ouctom. Observation : Patient 55 years old hypertensive known treated, who presented brutally 24 hours after a trauma at home with a fall and a reception on the head, headache vomiting and dizziness. The clinical examination objecti ied a left static and kinetic cerebellar syndrome. The brain scan showed spontaneous hyperdensity in the left cerebellum tent. Brain MRI showed a T2 hyper signal and a heterogeneous T2* signal at the left hemispheric subdural level. The patient was put on symptomatic treatment due to the absence of signs of severity of the disease with close monitoring. The evolution characterized by the improvement of the symptomatology after 2 weeks and the resorption of the hematoma on the control scanner at 3 weeks of evolution. Discussion and Conclusion : Post‑traumatic acute subdural hematoma of the posterior fossa cerebrum is a rare localization in the adult compared to other localizations. There are two essential physio pathological mechanisms. Clinical signs depend on the intensity of the hematoma. The clinical evolution is the spontaneous resorption of the hematoma remains possible para pots to this localization