Presentation
Dive into a shallow pool
Patient Data
An extra-axial extradural hemorrhage at the vertex, which crosses the midline, displacing the falx and the superior sagittal sinus inferiorly.
There is an overlying subgaleal hematoma, and an associated fracture involving the right parietal bone, extending into the sagittal suture.
Case Discussion
This case highlights one of the features that differentiates an extradural hemorrhage from a subdural hemorrhage - that is, EDH may cross a dural reflection - in this case, the falx. Interestingly, it does not uphold the caveat that an EDH may not cross a suture line, freely crossing the saggital surture.
There is however an associated fracture extending into the saggital suture, and this and the probable injury to the superior saggital sinus, likely account for this EDH disrespecting the suture line.
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