Severe Vertex Epidural Hematoma in a Child: A Case Report of a Management without Expert Neurosurgical Care

Abstract

Vertex epidural hematomas (VEDHs) are an uncommon situation and difficulties may be encountered in their diagnosis and management. This is more complicated when the surgical management has to be performed by general surgeons, not specialized in neurosurgery, in a remote location. It was in this context that we were brought to care in charge a 2-year-old boy who required a neurosurgical emergency rescue for a severe VEDH in Djibouti. Through the description of this case, we want to emphasize the value of developing a network of teleconsultation for the benefit of remote and isolated locations and learning basic techniques of emergency neurosurgery.

Figure 1

Axial and coronal CT scan images showing vertex epidural haematoma in preoperative course.

Figure 2

Sagittal and 3D CT scan images showing VEDH and frontal paramedian fracture extending down to the right orbital ceiling.

Figure 3

Scheme of incision for operative course and peroperative view.

Figure 4

Postoperative control axial CT scan.