Posterior fossa trauma

Abstract

Traumatic brain injury remains one of the leading causes of residual neurological and neuropsychological deficits in every age group independent from socioeconomic status. Posterior fossa trauma affects structures within the posterior fossa, that is, brainstem and cerebellum. It consists of intra-axial lesions such as contusions, hematoma or diffuse axonal injury, and extra-axial lesions such as epidural and subdural hematoma as well as subarachnoid hemorrhage. Imaging should guide surgical and conservative treatment. CT imaging is the method of choice since it is easier to conduct than MRI and readily available. However, in some cases, MRI is necessary to detect subtle lesions within the brainstem and to visualize long-term complications such as olivary pseudohypertrophy or superficial siderosis of the CNS. In spite of advances in intensive care management, especially control of raised intracranial pressure, and neurosurgical methods, mortality of posterior fossa trauma remains high and a high proportion of surviving patients exhibit substantial neurological deficits.