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

• Published in: Surgical neurology international Vol. 7; no. 11; pp. 276 - 278
• Main Authors: Navarro, Juliano, Alves, Raphael
• Format: Journal Article
• Language: English
• Published: United States Wolters Kluwer - Medknow Publications 2016; Medknow Publications & Media Pvt Ltd
• Subjects: Surgical Neurology International: Trauma; Cranial epidural hematoma; tomography; cranial sutures
• ISSN: 2152-7806; 2229-5097; 2152-7806
• DOI: 10.4103/2152-7806.181982

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.