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Vertex Extradural Hematoma: A Diagnostic Dilemma.
Jayendra Kumar1, Anand Prakash2, Viraat Harsh2
1Department of Neurosurgery, Narayan Medical College and Hospital, Sasaram, Bihar, India.
Asian Journal of Neurosurgery
|November 9, 2017
Summary
Extradural hematomas (EDHs) at the vertex are rare, often caused by superior sagittal sinus tears. This case highlights diagnostic challenges with vertex EDHs, emphasizing careful radiological review.
Area of Science:
- Neurosurgery
- Neuroradiology
- Traumatic Brain Injury
Background:
- Extradural hematomas (EDHs) are collections of blood between the dura mater and the skull.
- EDHs at the vertex represent a rare subset of all EDHs.
- Tears in the superior sagittal sinus are the typical etiology for vertex EDHs.
Observation:
- A 35-year-old male presented after a fall with a lucid interval.
- Imaging revealed frontal contusion, midline shift, and bilateral vertex EDHs.
- The vertex EDHs were initially misdiagnosed as artifact or subdural hematomas.
Findings:
- Vertex EDHs are uncommon and challenging to diagnose.
- Superior sagittal sinus injury is a common cause.
- Misinterpretation on imaging can delay diagnosis and treatment.
Implications:
- Accurate and timely diagnosis of vertex EDHs is crucial for patient outcomes.
- Radiological review must carefully consider the possibility of vertex EDHs.
- Understanding the etiopathology aids in managing this rare condition.
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