Turkish Neurosurgery
Surgical Technique for Draining a Concomitant Supra- and Infratentorial Epidural Hematomas
Alper Tabanli1, Hakan Yilmaz1
1University of Health Sciences Izmir Bozyaka Education and Research Hospital, Neurosurgery, IZMIR,
DOI: 10.5137/1019-5149.JTN.43250-22.4

Aim:Simultaneous acute supra- and infratentorial epidural hematomas rarely occur and reports in literature are limited. Infratentorial hematomas lead to quick deterioration and sudden death, and the associated complications are more significant than those in supratentorial hematomas, whose features can mask those of infratentorial epidural hematomas.Material and Methods:We retrospectively reviewed the clinical and radiological data of 18 patients with a concomitant acute supra- and infratentorial epidural hematoma, who were treated and followed up at our hospital. Results:The Glasgow Coma Score was 3–8 in four patients, was 9–12 in seven, and was 13–15 in seven patients. While the concomitant supra- and infratentorial hematoma did not cross the midline in 15 of the patients, it did in three of them. The sinus rupture was repaired in five of the patients. Functional healing was observed in 14 of the 18 patients. Two of the patients died during the postoperative period.Conclusion:A simultaneous supra- and infratentorial epidural hematoma rarely occurs in neurosurgical practice. Mortality and morbidity rates are high if these are not addressed in time. The radiological images of patients should be evaluated carefully preoperatively. In patients with a concomitant infra- and supratentorial hematoma, transverse sinus damage, which is a surgical challenge, should be considered. Herein, we describe a surgical technique (supra- and infratentorial craniotomy leaving the bone bridge over the transverse sinus) for draining a concomitant supra- and infratentorial epidural hematoma; this technique is an effective surgical choice in select patients.

Corresponding author : Alper Tabanli