Extradural hematoma at the vertex: a case report

Ramesh, Vengalathur Ganesan; Sivakumar, Subramaniam

doi:10.1016/0090-3019(95)80123-x

Cited by 16 publications

(20 citation statements)

References 3 publications

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“…Miller et al [11]added 2 more cases of vertex epidural hematomas, one of these being diagnosed at the time of admittance by coronal CT scans and MRI, the other after a symptom-free interval of 2 days again by CT scans that were at first judged to be normal and MRI that clearly demonstrated the hematoma. Coronal CT scans may lead to proper diagnosis but nowadays MRI is considered as being the best diagnostic method [10, 11, 12]. In our case initial CT scans demonstrated a parasagittal skull fracture and a very small extradural collection of blood in the most apical slices.…”

Section: Discussionmentioning

confidence: 88%

Vertex Epidural Hematoma with Communicating Bifrontal Subgaleal Hematomas Treated by Percutaneous Needle Aspiration

Strowitzkí¹,

Eymann²,

Schleifer

et al. 2001

Pediatr Neurosurg

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The case of an 11-year-old boy is presented who suffered a bicycle accident with a parasagittal skull fracture, a small vertex epidural hematoma, frontal contusions and a frontal subgaleal hematoma. Enlargement of the vertex epidural hematoma was diagnosed after development of a slight paraparesis on day 11 with the aid of MRI. Three percutaneous needle aspirations of the subgaleal hematoma with a total of 59 ml being evacuated led to quick recovery and disappearance of the subgaleal as well as the vertex epidural hematoma. It is speculated that both hematomas communicated via the skull fracture thus making the evacuation of the epidural hematoma by subgaleal punctures possible.

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Section: Discussionmentioning

confidence: 88%

Vertex Epidural Hematoma with Communicating Bifrontal Subgaleal Hematomas Treated by Percutaneous Needle Aspiration

Strowitzkí¹,

Eymann²,

Schleifer

et al. 2001

Pediatr Neurosurg

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“…Any doubts on axial CT scan should therefore prompt a neurosurgeon to do a coronal CT scan or MRI brain. MRI brain because of its multiplanar imaging can clearly delineate the hematoma (18,20). The first case in the literature in which MRI was used to diagnose a vertex EDH was reported by Ramesh in 1995 (18).…”

Section: Discussionmentioning

confidence: 99%

“…In our patient there was a linear fracture in both the parietal bones. Misinterpreting vertex EDH as an artifact is not rare (6,18,21). CT scan can easily miss an vertex EDH unless high axial cuts have been taken.…”

Section: Discussionmentioning

confidence: 99%

“…The course of management of vertex EDH is both conservative (6,11,14,16) and surgical (13,18,24). The factors which decide the type of management are clinical symptoms and signs, the Unlike EDH at other locations in the supratentorial area, a small volume at the vertex may need surgery as the pathophysiology is entirely different (21).…”

Section: Discussionmentioning

confidence: 99%

“…High axial cuts on CT scan can diagnose this entity; however care has to be taken not to mistake it for an artifact (16). MRI is a better modality and can confirm the diagnosis (18). Depending upon the size of the hematoma and the symptoms, the lesion can be managed conservatively or surgically (15,21).…”

Section: Introductionmentioning

confidence: 99%

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Vertex epidural hematoma with bilateral abducent nerve palsy-case report and literature review

Nayil¹,

Laharwal²,

Dhar³

et al. 2010

Turkish Neurosurgery

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Epidural hematomas which are located at the vertex are rarely seen and form a small percentage of total epidural hematomas. Tearing in the superior sagittal sinus is the usual cause of an epidural hematoma located in the vertex. The clinical features of this entity are non-specific; hence, localization of the lesion is difficult. We report an adult who was hit by a motorcycle and was initially discharged from the hospital as a case of concussional head injury. He returned back with raised intracranial pressure symptoms, so a CT scan was done but was misinterpreted, and he reported one week later with bilateral abducent nerve palsy. Magnetic resonance imaging confirmed vertex EDH for which he was operated.These hematomas are seen rarely and can be interpreted as an artifact. Its recognition is important because it has an excellent prognosis. We concluded that all head injury patients should get high axial cuts on the CT scan, and any degree of suspicion should prompt a neurosurgeon to investigate further with coronal CT scan or MRI. KeywOrds: Extradural hematoma, Vertex, Abducent nerve palsy ÖZVertekse yerleşmiş epidural hematomlar nadir görülürler ve tüm epidural hematomlar içinde küçük bir yüzde olarak bulunur. Bu hematomlara süperior sagital sinüsteki bir yırtık yol açar. Bu hematomların spesifik klinik bulguları olmadığından kafa içindeki yerini belirlemek çoğunlukla mümkün olmaz. Yaya halde iken motorsiklet tarafından çarpılan hastaya serebral kontüzyon tanısı konulmuş ve taburcu edildi, hasta tekrar hastaneye kafa içi basınç artışı bulguları ile getirildi ancak çekilen beyin bilgisayarlı tomografisinde patoloji yok denilerek hasta tekrar taburcu edildi. Hasta bir hafta sonra bu kez iki taraflı abdusent paralizisi ile hastaneye müracat etti ve yapılan kranial manyetik rezonans görüntülemesinde vertekste epidural hematom saptanan hasta ameliyat edildi. Vertekse yerleşmiş epidural hematomlar bilgisayarlı tomografide artefakt olarak değerlendirilerek kolayaca atlanabilir; bunun yanı sıra bu patoloji oldukça nadir görülür ve tanındığı zaman gerekli tedavi ile hastaların prognozu mükemmele yakındır. Kafa travması ile gelen hastaların özellikle vertikal bölgesi bilgisayarlı tomografi ile iyi taranmalı, şüphe durumunda koronal kesitler alınmalı, yine şüphe varsa hastalara kranial manyetik rezonans görüntülemesi yapılmalıdır.

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Traumatic Brain Injury

Imhof

Lenzlinger

2010

Head, Thoracic, Abdominal, and Vascular Injuries

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Extradural hematoma at the vertex: a case report

Cited by 16 publications

References 3 publications

Vertex Epidural Hematoma with Communicating Bifrontal Subgaleal Hematomas Treated by Percutaneous Needle Aspiration

Vertex Epidural Hematoma with Communicating Bifrontal Subgaleal Hematomas Treated by Percutaneous Needle Aspiration

Vertex epidural hematoma with bilateral abducent nerve palsy-case report and literature review

Traumatic Brain Injury

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