BILATERAL POSTERIOR FOSSA EPIDURAL

HEMATOMA AND SEQUEL DYSMETRIA:

CASE REPORT

Khatab
Muhammad Nazli Ferdian
Dedy Savradinata
Syahrul
Imam Hidayat
INTRODUCTION
Posterior fossa epidural hematoma (PFEDH)  an uncommon
diagnosis in the traumatic brain injury only about 4–7% of EDH

This condition has high mortality rate if it is not managed

immediately

Early diagnosis by CT imaging and EDH evacuation is very

important to improve patient outcome

Dysmetria is a condition in which there is improper measuring of

distance in muscular acts

Dysmetria occurs when lesions develop on cerebellum

CASE REPORT
• A 42-year-old woman presented to RSUDZA
emergency department with loss of conciousness
following traffic accident, 1 day before hospital
admission. She was referred from regional hospital

• At admission, her mental status was altered and she

had vomiting three times, she had nasal bleeding. On
clinical examination, Glasgow Coma Score (GCS) was
E2M5V2, her blood pressure was 140/70 mmHg and
her heart rate was 120 pulses per minute, she had
positive bilateral Babinsky reflex
CASE REPORT
• Routine laboratory tests showed mild leucocytosis
(12,000/mm3), and her hemoglobin was 8,9 g/dL. The
Computed tomography (CT) scan showed epidural
hematoma (EDH) at the cerebellum region, the estimation
of hematoma volume was 30 cc

• An emergency craniotomy was performed. Post-operatively,

the patient managed by a neurosurgeon and a neurologist.
The neurological deficit gradually revealed post-craniotomy.
Three days after surgery, the patient had dysmetria and
treated by a neurologist conservatively. He discharged on
post-operative day 5th.
Figure 1: Head CT scan showed EDH at
posterior fossa (the estimation of
hematoma volume: 30 cc)
CONCLUSION
• PFEDH is uncommon in the traumatic brain
injury and is only about 4-7% of all EDHs
• Early diagnosis and evacuation is very important
to improve patient outcome
• Dysmetria is one of sequel after lesion in
posterior fossa, especially that affects the
cerebellum
THANK YOU