Missed diagnosis; non-traumatic retroclival haematoma in adults, brief case report with review and evaluation of similar cases in the literature


GÜVERCİN A. R., AKTOKLU M., Orbay Bıyık M. O., YAZAR U.

NEUROCIRUGIA, cilt.36, sa.4, 2025 (SCI-Expanded, Scopus) identifier identifier

  • Yayın Türü: Makale / Derleme
  • Cilt numarası: 36 Sayı: 4
  • Basım Tarihi: 2025
  • Doi Numarası: 10.1016/j.neucir.2025.500664
  • Dergi Adı: NEUROCIRUGIA
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, EMBASE, MEDLINE, DIALNET
  • Anahtar Kelimeler: Anticoagulant therapy, Emergency diagnosis, Non-traumatic intracranial hemorrhage, Posterior fossa hemorrhage, Retroclival subdural haematomas
  • Karadeniz Teknik Üniversitesi Adresli: Evet

Özet

Retroclival subdural haematomas (RSH) are a rare occurrence, accounting for 0.3% of acute extra-axial haematomas. Although typically associated with trauma, non-traumatic causes include coagulopathy, pituitary apoplexy and vascular anomalies.The presence of cases due to non-traumatic causes can present significant diagnostic challenges. This article aims to shed light on the intricacies of non-traumatic RSH by conducting a review of the literature and presenting a case study of a 74-year-old woman on anticoagulants. The primary objective is to enhance our understanding of the diagnosis and treatment of this condition, emphasising the significance of bleeding in a location that often goes unnoticed, particularly in Computed Tomography (CT) scans, with the exception of trauma. A comprehensive review of the literature revealed 28 cases of non-traumatic RSH in adults. A detailed analysis was conducted on the demographic characteristics, causes, presentations and outcomes of these cases.The mean patient age was found to be 59 years, with a slight male predominance of 57.57%. The primary causes were identified as pituitary apoplexy (39.28%) and anticoagulants (21.42%), while 25% of cases had an unknown aetiology. Spinal canal extension occurred in 10.71% of cases, which increased morbidity.The recovery rate was 92.85% and the mortality rate was 3.57%.Non-traumatic RSH is under-recognised and often missed on standard imaging.Conservative treatment is effective without spinal cord compression.Awareness is very important, especially for diagnosis and treatment. (c) 2025 Sociedad Espanola de Neurocirug & imath;a. Published by Elsevier Espana, S.L.U. All rights are reserved, including those for text and data mining, AI training, and similar technologies.