Abstract：
Posterior fossa epidural hematoma (PFEDH) is rare which accounts for just 4-12.9% of all EDH cases. Since its frequently subtle and nonspecific clinical presentation, CT scan has great importance for early diagnosis and treatment of PFEDH. However, indications for surgery depending on the findings of CT image are still controversial.
We retrospectively analyzed 40 pediatric cases of PFEDH. Their baseline characteristic, clinical presentation, imaging findings and outcomes were collected and analyzed. The ellipsoid volume equation X × Y × Z/2 was used to measure the hematoma volume. The Glasgow Outcome Scale (GOS) was used to assess the neurologic functional outcome.
A total of 40 pediatric PFEH patients were included with 8 patients having poor outcome and 32 patients having a relatively good prognosis. GCS score showed a significant difference between good and poor outcome groups (p < 0.001). Y value on CT image was significantly bigger in poor outcome group than good outcome group (p < 0.01). Similar results were got in X/Z value (p < 0.05) and Y/Z value (p < 0.01) which reflected the shape of hematoma. A predictive model with Y + X/Z showed the largest area under the ROC curve with a sensitivity of 75.0% and specificity of 93.7%.
GCS score at admission was closely related to the prognosis of the pediatric patients with PFEDH. The morphometry of PFEDH has a crucial role in judging the prognosis. Axial convex-shaped hematoma was associated with poor curative effect of surgical treatment.
We retrospectively analyzed 40 pediatric cases of PFEDH. Their baseline characteristic, clinical presentation, imaging findings and outcomes were collected and analyzed. The ellipsoid volume equation X × Y × Z/2 was used to measure the hematoma volume. The Glasgow Outcome Scale (GOS) was used to assess the neurologic functional outcome.
A total of 40 pediatric PFEH patients were included with 8 patients having poor outcome and 32 patients having a relatively good prognosis. GCS score showed a significant difference between good and poor outcome groups (p < 0.001). Y value on CT image was significantly bigger in poor outcome group than good outcome group (p < 0.01). Similar results were got in X/Z value (p < 0.05) and Y/Z value (p < 0.01) which reflected the shape of hematoma. A predictive model with Y + X/Z showed the largest area under the ROC curve with a sensitivity of 75.0% and specificity of 93.7%.
GCS score at admission was closely related to the prognosis of the pediatric patients with PFEDH. The morphometry of PFEDH has a crucial role in judging the prognosis. Axial convex-shaped hematoma was associated with poor curative effect of surgical treatment.
摘要：
背景：后颅窝硬膜外血肿（PFEDH）很少见，仅占所有EDH病例的4-12.9％。由于其通常是微妙和非特异性的临床表现，CT扫描对PFEDH的早期诊断和治疗具有重要意义。然而,根据CT图像的发现进行手术的指征仍然存在争议。
方法：我们回顾性分析了40例小儿PFEDH。他们的基线特征，临床表现,收集并分析影像学表现和结局.采用椭球体积方程X×Y×Z/2测量血肿体积。格拉斯哥预后量表（GOS）用于评估神经功能结局。
结果：共纳入40例小儿PFEH患者，其中8例患者预后较差，32例患者预后较好。GCS评分在好和差结果组之间显示出显着差异（p<0.001）。结果不良组的CT图像Y值明显大于结果良好组（p<0.01）。X/Z值（p<0.05）和Y/Z值（p<0.01）反映了血肿的形态。Y+X/Z预测模型显示ROC曲线下面积最大,敏感性为75.0%,特异性为93.7%。
结论：入院时GCS评分与PFEDH患儿的预后密切相关。PFEDH的形态计量学在判断预后中起着至关重要的作用。轴向凸状血肿与手术治疗效果差有关。
方法：我们回顾性分析了40例小儿PFEDH。他们的基线特征，临床表现,收集并分析影像学表现和结局.采用椭球体积方程X×Y×Z/2测量血肿体积。格拉斯哥预后量表（GOS）用于评估神经功能结局。
结果：共纳入40例小儿PFEH患者，其中8例患者预后较差，32例患者预后较好。GCS评分在好和差结果组之间显示出显着差异（p<0.001）。结果不良组的CT图像Y值明显大于结果良好组（p<0.01）。X/Z值（p<0.05）和Y/Z值（p<0.01）反映了血肿的形态。Y+X/Z预测模型显示ROC曲线下面积最大,敏感性为75.0%,特异性为93.7%。
结论：入院时GCS评分与PFEDH患儿的预后密切相关。PFEDH的形态计量学在判断预后中起着至关重要的作用。轴向凸状血肿与手术治疗效果差有关。
