A CASE REPORT ON TRAUMATIC DELAYED EPIDURAL HEMATOMA WITH ATYPICAL PRESENTATION
Abstract
Vertex epidural hematoma (EDH) is an uncommon type of EDH. The management of vertex EDH is a challenge for neurosurgeons, as there is no proper consensus on the proper treatment modality. Our patient had delayed clinical deterioration with the development of paraparesis and deep somnolent state. After an immediate head CT was performed, which showed massive delayed EDH at the vertex, the patient underwent an urgent operation. The postoperative course went satisfactorily with the complete withdrawal of all neurological deficits and control head CT scan showed the complete evacuation of the hematoma. Vertex EDH represents an urgent neurosurgical pathology, which should not be diagnostically overlooked, and by need treated urgently in the operating room.
References
Dobbs TD, Barber ZE, Squier WL, Green AL. Cerebral venous sinus thrombosis complicating traumatic head injury. J Clin Neurosci 2012;19(7):1058-9. [CrossRef] [PubMed]
Eroglu U, Zaimoğlu M, Sayacı EY, Ugur HC, Attar A, Kahilogullari G, et al. Is Placing Prophylactic Dural Tenting Sutures a Dogma? World Neurosurg 2021; 153:e403-7. [CrossRef] [PubMed]
Fernandes-Cabral DT, Kooshkabadi A, Panesar SS, Celtikci E, Borghei-Razavi H, Celtikci P, et al. Surgical management of vertex epidural hematoma: technical case report and literature review. World Neurosurg 2017;103:475-83. [CrossRef] [PubMed]
Jones TL, Crocker M, Martin AJ. A surgical strategy for vertex epidural haematoma. Acta Neurochir 2011; 153(9):1819-20. [CrossRef] [PubMed]
Kostić A, Veselinović A, Nikolov V, Stefanović I, Mitić R, Radisavljević M, et al. A combination of acute and delayed contralateral epidural hematoma. Srp Arh Celok Lek 2018;146(3-4):193-6. [CrossRef]
Navarro JN, Alves RV. Vertex epidural hematoma: A rare cause of post-traumatic headache and a diag-nostic challenge. Surg Neurol Int 2016;7(Suppl 10): S276. [CrossRef] [PubMed]
Ramesh VG, Kodeeswaran M, Deiveegan K, Sundar V, Sriram K. Vertex epidural hematoma: An analysis of a large series. Asian J Neurosurg 2017;12(2):167. [CrossRef] [PubMed]
Rosenthal AA, Solomon RJ, Eyerly-Webb SA, Sanchez R, Lee SK, Kiffin C, et al. Traumatic epidural hema-toma: patient characteristics and management. Am Surg 2017;83(11):438-40. [CrossRef] [PubMed]
Salunke P, Sodhi HB, Aggarwal A, Ahuja CK, Dhandapani SS, Chhabra R, et al. Is ligation and division of anterior third of superior sagittal sinus really safe? Clin Neurol Neurosurg 2013;115(10): 1998-2002. [CrossRef] [PubMed]
Tzeng PR, Chen YK, Hsi SC. Vertex epidural hema-tomas caused by injury of the superior sagittal sinus. Formos J Surg 2012;45(1):20-4. [CrossRef]
Winston KR. Efficacy of dural tenting sutures. J Neurosurg 1999;91(2):180-4. [CrossRef] [PubMed]
Yilmazlar SE, Kocaeli H, Dogan S, Abas F, Aksoy K, Korfali E, et al. Traumatic epidural haematomas of nonarterial origin: analysis of 30 consecutive cases. Acta Neurochir 2005;147(12):1241-8. [CrossRef] [PubMed]