Retroclival epidural hematoma: A rare location of epidural hematoma, case report, and review of literature

ÇAĞLAR Y. Ş., Erdogan K., Kilinc C. M., Mammadkhanli O., ÖZGÜRAL O., EROĞLU Ü.

JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE, vol.11, no.4, pp.342-346, 2020 (ESCI) identifier identifier identifier

  • Publication Type: Article / Review
  • Volume: 11 Issue: 4
  • Publication Date: 2020
  • Doi Number: 10.4103/jcvjs.jcvjs_97_20
  • Journal Name: JOURNAL OF CRANIOVERTEBRAL JUNCTION AND SPINE
  • Journal Indexes: Emerging Sources Citation Index (ESCI), Scopus, Academic Search Premier, EMBASE, Directory of Open Access Journals
  • Page Numbers: pp.342-346
  • Keywords: Dural venous anatomy, retroclival hematoma, thrombocytopenia, warfarin, INFARCTION, HEMORRHAGE, SECONDARY, FRACTURE
  • Ankara University Affiliated: Yes

Abstract

Retroclival epidural hematoma in adults is uncommon. Although most cases are associated with craniocervical trauma, other mechanisms have been reported, such as coagulopathy, vascular lesions, and pituitary apoplexy. We report two adults diagnosed with retroclival epidural hematoma. One patient was an 89-year-old male with leukemia and thrombocytopenia who sustained a fall and developed a traumatic retroclival epidural hematoma with brainstem compression; surgery could not be performed due to his clinical condition and he died 5 days later. The other patient was a 78-year-old female with atrial fibrillation who developed a spontaneous retroclival epidural hematoma as a result of warfarin use; she was treated conservatively with anticoagulant reversal and methylprednisolone and was subsequently discharged without neurological deficit. Retroclival hematomas are primarily treated conservatively due to the difficulty of surgical approach. The bleeding mechanism and dural and venous anatomy of this region tend to limit hematoma expansion.