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. 2016 May 6;7(Suppl 10):S276-8.
doi: 10.4103/2152-7806.181982. eCollection 2016.

Vertex epidural hematoma: A rare cause of post-traumatic headache and a diagnostic challenge

Juliano Nery Navarro  1 , Raphael Vicente Alves  1
Affiliations

Vertex epidural hematoma: A rare cause of post-traumatic headache and a diagnostic challenge

Juliano Nery Navarro et al. Surg Neurol Int. .

Abstract

Background: Vertex epidural hematomas (VEH) account for only 8% of all epidural hematomas. However, these traumatic injuries may be underestimated or overlooked altogether when only computed tomography (CT) scans are used for diagnosis. The vertex may be a potential anatomic "blind spot" on this radiological method. In such cases, magnetic resonance (MRI) offers a great diagnostic aid.

Case description: This manuscript reports a patient of a head trauma who developed progressive and intractable headache. MRI made the diagnosis of progressive VEH and highlighted the detachment of the superior sagittal sinus by the hematoma. Surgical treatment, because of the refractory clinical findings, was performed with good postoperative recovery.

Conclusion: Multiple trauma patients with progressive and refractory headache should have their head CT thoroughly reviewed and, if necessary, be investigated with MRI.

Keywords: Cranial epidural hematoma; cranial sutures; tomography.

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Figures

Figure 1
Figure 1
Brain CT showing biconvex high density in vertex
Figure 2
Figure 2
(a) Sagittal brain MRI T1-weighted identifying isointense image detaching the superior sagittal sinus. (b) Coronal brain MRI T2-weighted identifying isointense image detaching the superior sagittal sinus. (c) Brain CT showing complete evacuation of the hematoma
Figure 3
Figure 3
Intraoperative image showing the epidural hematoma detaching the superior sagittal sinus
See this image and copyright information in PMC

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