Hematoma extradural do vértex: relato de caso

Haikel, Luiz Fernando Júnior; Listik, Sérgio; Rodrigues, José Carlos; Viterbo, Marcelo Barletta Soares; Pereira, Clemente A Brito

doi:10.1590/s0004-282x2005000200032

Cited by 2 publications

(9 citation statements)

References 13 publications

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“…Vertex epidural hematomas are rare and frequently associated to bleeding from the venous sinus, bone fracture or dural diffuse bleeding (arterioles). 7 They must be considered a special clinical entity because of their presentation and vascular etiology. 1 Clinical suspicion relies on the symptoms of the coronais na tomografia.…”

Section: Discussionmentioning

confidence: 99%

“…4 There are a lot of reported cases of VEH. 1,[5][6][7] We describe in the present article a rare and extremely large VEH with central brain herniation, and provide a technical note on the surgical planning and treatment.…”

Section: Introductionmentioning

confidence: 95%

“…In cases in which the SSS is damaged, the clinical course is more acute, with elevation of intracranial pressure (ICP) and brain herniation. 7,8 When the bleeding comes from other sources, the clinical symptoms and the evolution are more indolent.…”

Section: Palavras-chavementioning

confidence: 99%

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Large Vertex Epidural Hematoma: Case Report and Review of Surgical Approaches

et al. 2019

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Vertex epidural hematomas (VEHs) are a special clinical entity due to their clinical presentation, vascular etiology and options of surgical approach. The clinical suspicion involves recognizing the mechanism of the injury and the correct visualization of the hematoma in computed tomography (CT) coronal sequences. In the present article, we describe a case of a very large (146 mL) VEH with central brain herniation, and provide a technical note on the surgical planning and treatment. A 34-year-old male patient was admitted to the hospital after an injury on the left superior parietal region. The Glasgow coma scale score was 6, and the left pupil of the patient was dilated. The CT scan showed a large epidural hematoma on the vertex between the coronal e lambdoid sutures, and a fracture over the sagittal suture. During the surgery, multiple burr holes were made laterally to the sagittal suture, and after inspection and no visualization of bleeding in the superior sagittal sinus (SSS), we performed a standard biparietal craniotomy. The patient was discharged three days after the surgery without any deficits. Currently, with the improvement in imaging modalities, more cases of VEH are being identified. Identifying the etiology prior to the craniotomy is challenging in severe cases. Tears in the SSS can bleed profusely, and they demand strategies during the craniotomy. With multiple burr holes parallel to the sagittal suture, we can visualize whether there is bleeding in the SSS and design a craniotomy with or without a central osseous bridge to anchor the dura. Neurosurgeons must be prepared to plan a surgical strategy in cases of large VEHs. Due to its rare frequency and bleeding risks, VEHs are considered challenging. ResumoO hematoma epidural do vértex (HEV) é uma entidade clínica especial particularmente por sua sintomatologia, etiologia vascular e tratamento. A suspeita clínica envolve o reconhecimento do mecanismo do trauma e a correta visualização de sequências

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 95%

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Large Vertex Epidural Hematoma: Case Report and Review of Surgical Approaches

et al. 2019

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“…Dentre eles, uma apresentação especial e de rara incidência, porém de alta letalidade, corresponde aos hematomas epidurais localizados no vértex craniano. Geralmente são causados por sangramento do seio sagital superior (SSS) e suas tributárias, devido a fraturas na região do vértex ou diástase das suturas sagital ou coronal 1,6,16,17 .…”

Section: Introductionunclassified

“…O diagnóstico é, na maioria dos casos, tardio devido à localização singular do sítio de sangramento, não amparada por achados tomográficos e, ainda, por ausência de sinais localizatórios claros 2,6 . Objetivamos relatar um caso de hematoma epidural traumático do vértex de manifestação bilateral com sucesso diagnóstico e terapêutico.…”

Section: Introductionunclassified

Hematoma epidural bilateral do vértex

Júnior¹,

Viana²,

Pantoja³

et al. 2018

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Hematoma epidural do vértex é considerado raro e a bilateralidade é incomum. Geralmente ocorrem por fraturas do vértex que comprometem o seio sagital superior. Devido à sua localização e apresentação clínica, o diagnóstico é tardio. Esta condição requer, portanto, alto grau de suspeição na abordagem dos traumatismos crânio-encefálicos, com vista a diminuir a alta morbimortalidade por essa entidade. Relatamos o caso de paciente com extenso hematoma epidural traumático do vértex com apresentação bilateral, diagnosticado através de tomografia computadorizada de crânio em cortes axiais e submetido à craniotomia biparietal para drenagem do hematoma.

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Hematoma extradural do vértex: relato de caso

Cited by 2 publications

References 13 publications

Large Vertex Epidural Hematoma: Case Report and Review of Surgical Approaches

Large Vertex Epidural Hematoma: Case Report and Review of Surgical Approaches

Hematoma epidural bilateral do vértex

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