Book craniotomy: modified craniotomy for midline extradural hematoma. Patient series

Area of Science:

• Neurosurgery
• Trauma Surgery

Background:

• Extradural hematoma (EDH) involves blood collection between the dura and skull/spine.
• While typically traumatic and temporal, midline or vertex EDH from venous bleeds is rare.

Purpose of the Study:

• To present a case series of vertex EDH.
• To evaluate the efficacy of book craniotomy for midline EDH management.

Main Methods:

• Retrospective case series of 9 patients with vertex EDH.
• Analysis of road traffic accidents as a common cause.
• Consideration of book craniotomy in all cases, especially with sinus injury risk.

Main Results:

• Road traffic accidents were the most common cause.
• Vertex EDH was the predominant type observed.
• Sinus injury was identified in 5 cases; no patient mortality occurred.

Conclusions:

• Midline EDH demands specialized care due to potential for significant blood loss and morbidity from sinus injury.
• Book craniotomy is an innovative technique to protect sinuses and achieve hemostasis in midline EDH cases.