Chronic Subdural Hematoma in the Posterior Fossa

Chronic subdural hematoma (CSH) in the posterior fossa is exceedingly uncommon among adults. Computed tomography (CT) scanning is generally dependable and sufficiently sensitive in the diagnosis of supratentorial subdural hematomas, while magnetic resonance imaging (MRI) has demonstrated its superiority in identifying subdural collections in atypical locations, especially within the posterior cranial fossa, with more detailed analysis. The choice of surgical approach remains a subject of debate. Here, we present a single case of CSH in the posterior fossa that was managed through a suboccipital craniectomy. In this case, a 70-year-old man developed symptoms including headaches, nausea, cerebellar syndrome, and unsteady walking. Radiological assessments revealed the presence of a right-sided CSH within the posterior fossa, along with hydrocephalus. Due to a rapid deterioration in the patient's level of consciousness, urgent intervention was warranted. A small suboccipital craniectomy on the right side was performed to access the hematoma. Subsequent postoperative computed tomography demonstrated successful resolution of both the CSH and hydrocephalus.