Chirurgie des hématomes spontanés de la fosse cérébrale postérieure à Abidjan de 2007 à 2013.

Spontaneous hematomas of the posterior cranial fossa rapidly evolve unfavourably. The concomitant involvement of the ventricles, cerebellum and brainstem is almost a constant, calling for emergent decompression by the surgeon. In the sub-saharan setting, this surgery is adapted to the context and the basis and parameters of this adaptation are specified and evaluated. The aim of thisstudy wasto evaluate the post-operative morbidity and mortality of posterior cranial fossa haematomas in our surgical experience. We carried out a retrospective study, from January 2007 to December 2013, including files of patients admitted with a radioclinical confirmed diagnosis of non-traumatic hematoma of the posterior fossa. The Glasgow Coma Scale, Outcome (GCS/GOS), and modified Rankin (mRS) were used. We retained 13 patients’files. The mean age was of 54.5 years and the sex-ratio was 1.6. The most common topography was the cerebellar hemisphers (46.15%). Postoperatively, we noticed a relative improvement in the mean preoperative GCS fro 8.07 to 10. External ventricular shunt (5 cases) and sub-occipital craniotomy with removal of clots (5cases) were the most performed surgeries. No ventriculocisternostomy was carried out. The postoperative clinical status was mostly marked by moderate to severe handicap (GOS ≤ 2 or mRS ≥ 4) and the mortality rate was 30.7%. Posterior cranial fossa hematomas remain rare and mostly disabling in our context. They require a prompt and adapted surgical reaction depending on the site of the hematoma, the size of the clot and the initial level of consciousness [ABSTRACT FROM AUTHOR]