Vertex epidural hematoma. Case report and literature review
Hematoma epidural de vértice. Reporte de caso y revisión de la literatura
Carlos Umberto Pereira, Gabriela Ferreira Kalkmann
Abstract
Introduction: The vertex epidural hematoma (VEH) is considered an infrequent post-traumatic extradural blood collection, formed by rupture of the superior sagittal sinus (SSS) and venous gaps, with an incidence of 0 to 8%. Objective: to present a VEH case, associated with a literature review. Case presentation: The patient presented with cervical pain, associated with falling from a motorcycle without wearing a helmet, admission Glasgow coma scale of 12, lower limbs paresis, and muscle strength grade 3 in the lower limbs. The skull computerized tomography (CT) evidenced extensive biparietal epidural hematoma, associated with bilateral motor cortex compression. He was submitted to the right parietal osteoplastic craniotomy with left extension, associated with blood clot drainage and small laceration suture in the SSS middle portion. Patient was discharged with no evident neurological deficit. Conclusion: The vertex epidural hematoma is an uncommon condition among cases of epidural hematoma. Its early diagnosis, performed mainly by axial CT and the appropriate treatment, has good results
Keywords
Resumen
Introducción: El hematoma epidural de vértice (HEV) se considera una colección sanguínea extradural postraumática infrecuente, formada por ruptura del seno sagital superior (SSS) y brechas venosas, con una incidencia de 0 a 8%. Objetivo: Presentación de un caso de HEV, asociado a una revisión de la literatura. Reporte del caso: El paciente presentó dolor cervical, asociado a caída de una motocicleta sin usar casco, ingresó en la escala de coma de Glasgow de 12, paresia de miembros inferiores y fuerza muscular grado 3 en los miembros inferiores. La tomografía computarizada (TC) de cráneo evidenció un extenso hematoma epidural biparietal, asociado a compresión de la corteza motora bilateralmente. Siendo sometido a craneotomía osteoplástica parietal derecha con extensión a la izquierda, asociada a drenaje de coágulo sanguíneo y pequeña sutura de laceración en la porción media del SSS. Siendo dado de alta sin déficit neurológico evidente. Conclusión: El hematoma epidural de vértice es una condición poco común entre los casos de hematoma epidural. Su diagnóstico precoz, realizado principalmente mediante TC axial, y el tratamiento adecuado ofrecen buenos resultados.
Palabras clave
References
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Submitted date:
04/11/2025
Accepted date:
04/15/2025
Publication date:
07/14/2025
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