Rapid disappearance of acute posterior fossa epidural hematoma.

A 34-year-old man presented with an acute epidural hematoma that resolved within 24 hours after a fall. On admission, neurological examination found no abnormalities. Computed tomography (CT) indicated a linear fracture in the occiput. Four hours after the injury, the patient's condition worsened and repeat CT showed a bilateral epidural hematoma in the posterior fossa extending over the bilateral transverse sinuses and severe brain swelling. The patient's family refused surgery. Conservative management with pentothal was performed in the intensive care unit. Follow-up CT 21 hours after the initial injury showed complete resolution of the hematoma and an increase in the CT density of the pericranial soft tissue near the hematoma. The pressure gradient between the subgaleal and epidural space may have been important in the rapid disappearance of this epidural hematoma.