Posterior cranial fossa epidural hematoma is a special type of hematoma in craniocerebral trauma and has its own unique clinical characteristics. Causes of injury Falling injuries, car accident injuries, percussion injuries, etc. All of them are caused by direct violence to the occipital roof or occipital area. The typical manifestations of posterior cranial fossa hematoma are headache, vomiting, impaired consciousness, cervical tonicity, optic papilla edema, cerebellar, brainstem and posterior group cranial nerve signs, and after the application of CT and MRI, typical cases are rare. The clinical manifestations of PFEDH alone are mild and nonspecific, unless accompanied by primary brainstem injury or with severe supratentorial cerebral contusion with hematoma, often manifesting only as headache or with vomiting, with few positive neurological signs found to. Therefore, any occipital trauma with severe headache, frequent vomiting, mental disorder, occipital scalp injury changes, and cranial X-ray showing occipital fracture should be considered for the diagnosis of PFEDH, and early CT and MRI examination should be pursued. Special emphasis is placed on the special status of occipital trauma and occipital fracture in the diagnosis of PFEDH. Cranial MRI scans and cranial radiographs can reveal riding epidural hematoma, subepidural epidural hematoma (with intracerebellar hematoma), concurrent hedgehog frontal, temporal, parietal cerebral contusions or concurrent hematoma with quadruple ventricular compression deformation, displacement, mild obstructive hydrocephalus, etc. Occipital fractures are seen on cranial radiographs. Morbidity and mortality PFEDH accounts for 1.4% to 5.8% of closed craniocerebral injuries, 3.4% of all epidural hematomas, and 75% of all posterior cranial fossa hematomas. Before the introduction of CT, the diagnosis of PFEDH was difficult, and the prognosis was more dangerous, with a mortality rate of more than 40%, which has decreased significantly after the application of CT and MRI. The “age” of the hematoma has been reported to be divided into acute (within 24 h), subacute (2-7 d), and chronic (more than 8 d) according to the time from injury to diagnosis. It is believed that PFEDH is different from supratentorial epidural hematoma, which is mostly caused by blood leakage from the surface of the transverse sinus or the plate barrier at the fracture and blood leakage from the dural surface, with relatively slow bleeding and more common with subacute onset. We believe that due to the widespread use of CT and MRI examinations and increased vigilance for PFEDH, the vast majority of cases can be scanned and examined in a timely manner, and thus acute hematomas are diagnosed early, and some smaller PFEDH are also detected. Treatment Before the application of CT and MRI, it was believed that all PFEDH should be surgically removed from the hematoma. With the widespread use of CT and MRI scans, PFEDH can now be diagnosed early, and some smaller PFEDH have also been identified. We believe that PFEDH with a hematoma volume of less than 12 mL located entirely below the transverse sinus and a riding epidural hematoma with a hematoma volume of less than 20 mL, with stable clinical symptoms and signs, no significant compression of the four ventricles and brainstem pools on cranial CT and MRI, and no other combined brain injuries The patient can be treated conservatively under good surgical preparation and close clinical observation and CT and MRI monitoring.