The aim of this study is to investigate the interactions between prognostic factors and functional outcome of patients managed posterior fossa epidural hematomas (PFEDH) in childhood.

Between 2002 and 2004, fourteen patients were treated for the PFEDH. The medical records and radiologic findings of the patients were reviewed retrospectively. Information on potential prognostic factors was collected and compared with literatures.

Initial Glasgow Coma Scale scores of thirteen patients were 15 and 14 in one case. Occipital skull fractures were found in seven cases (50%). The degree of compression of the fourth ventricle and quadrigeminal cistern measured on computed tomography scan. Five cases showed mild compression and nine cases showed normal. Thirteen patients were managed by conservative manner, however, three cases were operated. All patients experienced good outcomes (Glasgow Outcome Scale scores of 5).

When occipital trauma and/or fracture is diagnosed, CT should be always performed. The suspicion of a slower course of the posterior fossa epidural hematoma or a delayed hematoma should be kept in mind when dealing with an occipital trauma or fracture, even after initial negative CT was confirmed shortly after the trauma.