The Hidden Hematoma of the Head: Analysis of Vertex EDHs and their Outcome
Journal Title: International Journal of Neurology and Neurosurgery - Year 2019, Vol 11, Issue 3
Abstract
Context: The skull vertex is an uncommon site for epidural hematoma (EDH) formation. The usual cause of a hematoma is a tear in the sagittal sinus due to trauma or saggital suture diastasis. Vertex EDH, even of small volumes, can cause rapid neurologic deterioration and death. Hence, rapid diagnosis is important to limit morbidity and mortality. There are only few isolated case reports or small series of VEDH in the literature. We analysed all cases of VEDH managed at our trauma centre over the last 10 years. Case records of all traumatic brain injury were analysed. Aims: To analyze a series of VEDH patients seen in our institute. Settings and Design: Retrospective observational study. Subjects and Methods: This is an analysis of case records of patients with VEDH during 10 years period from 2008 to 2018. Statistical Analysis Used: Nil. Results: Twenty cases of VEDH were encountered over a period of 10 years, which included 17 males and 3 females. The majority of cases were due to road traffic accidents, and most of these presented with altered sensorium. The diagnosis was made by axial and coronal sections of computerized tomography (CT) scan. 16 patients were operated and 4 managed conservatively. The most common source of bleeding was superior sagittal sinus. One patient expired during treatment. Conclusions: A high degree of suspicion should be maintained to diagnose vertex EDH as it may be easily missed especially working in a high workload trauma centre. Early diagnosis and judicious decision with regards to surgery and medical management is the key for successful treatment in these cases. This is second largest case series reported so far.
Authors and Affiliations
SK Singh
Keywords
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- EP ID EP669529
- DOI 10.21088/ijnns.0975.0223.11319.6
- Views 67
- Downloads 0
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